Are people changed by the experience of having an episode of depression? A further test of the scar hypothesis

Article Abstract:

It is known that people who have had one episode of depression are at increased risk for having another, compared with those who have not been depressed. Therefore, it is hypothesized that individuals with a history of depression possess characteristics which predispose them to depression, and that they may be distinguished from those who do not have this particular vulnerability. To further investigate this possibility, which has been termed the 'scar hypothesis', 49 subjects over the age of 50 were assessed before and after their first depressive episode using a number of tests and interviews which included the Schedule for Affective Disorders and Schizophrenia and the Longitudinal Interview Follow-up Evaluation. A number of independent variables were also evaluated by questionnaire; these included demographic factors, physical health, stress, availability of social supports, and interpersonal relationships. The patients with depression were compared with 351 individuals who had never been depressed; this was the control group. The findings were consistent with previous studies. Individuals with depression were more likely to be female, younger, and to have mild depression both before and after the depressive episode. Once the patients had recovered, they were more likely to report poorer health, diminished social skills, and greater interpersonal dependency than the controls. After the application of a number of statistical comparisons, no significant differences were found which could be considered a psychosocial scar or which emerged as a predictive characteristic in the depressed group. A variety of ways to approach the interpretation of these results are discussed. It is possible that individuals who have been depressed develop a tendency to perceive themselves as less skilled socially after the episode of depression when compared with the controls. Additional studies in this area are recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Risk factors, Prognosis

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Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults

Article Abstract:

Comorbidity refers to the likelihood that one disorder will be present concurrently with another, and also refers to the tendency for each disorder to affect the course of the other. Comorbidity studies of depression and other psychiatric disorders are relatively new, but evidence suggests that there are relationships between depression and anxiety disorders, substance abuse, conduct disorder, and somatic disorders. In the present study, comorbidity data were obtained for 1,710 adolescents and 2,060 adults. Data included current and past history of depression and other mental disorders, and it was found that for adolescents there was a higher comorbidity of depression and other mental disorders than for adults (though the level of comorbidity for adults was also significant). For both groups, depression was most likely to be seen after the onset of the other disorder, and it was unaffected in duration or severity by the other disorder. Depressed adolescents with other psychiatric disorders were more likely to demonstrate suicidal ideation and to seek treatment than depressed adolescents without a comorbid disorder. The results suggest that early onset of depression is associated with a greater comorbidity with other psychiatric illnesses, and may be more severe than depression that develops later in life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Mental illness, Mental disorders

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Comorbidity of unipolar depression: I. major depression with dysthymia

Article Abstract:

In the 1970s, researchers demonstrated that people with one psychiatric disorder may suffer from another as well, and one disorder may affect the course of the other; this is called comorbidity. To study the comorbidity of major depression and dysthymia, a milder but more chronic form of depression, 1,710 adolescents and 2,060 adults were studied. Assessment of current and past mental status was made for each subject, and diagnoses were made. Data on treatment for depression were obtained as well. It was found that the comorbidity between major depression and dysthymia was higher than expected. Specifically, adolescents with major depression were about three times more likely to develop dysthymia than were adolescents without major depression, and for adults with major depression the likelihood of developing dysthymia was about 50 percent higher than for adults without evidence of major depression. Dysthymia was more likely to occur before major depression rather than after it. If depression was experienced twice, the second episode was more likely to be major depression regardless of what the first episode was. Most subjects (90 percent), however, suffered only a single form of depression, and depression of any kind was associated with the comorbidity of other psychiatric disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Statistics, Teenagers, Youth

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