[Recurrent depression and life events: ACTUEL survey]

The impact of stressful life events in triggering major depressive episodes has been extensively studied since 30 years. The results of these studies however, have been controversial, due to limitations in assessment tools and lack of power.

This paper shows the results of the ACTUEL survey, conducted in a sample of 13,377 depressed patients. The aim of this survey is to study the relationship between the number of previous depressive episodes and the life event exposure triggering the current depressive episode.

Increasing number of previous depressive episodes was significantly associated with a linear increase in age, severity of depression, percentages of female gender and family history of depression. Increasing number of previous depressive episodes was also associated with a linear decline in life event exposure triggering the current depressive episode. The decline in life event exposure was itself unrelated to the other confounding variables.

This study provides support for the kindling hypothesis of unipolar major depressive disorders: as the number of previous depressive episodes increases, even minor life events may trigger a new depressive episode. This paper also discusses these clinical data in terms of recent cerebral imagery and biological data, which may be relevant regarding the etiopathogeny and treatment of major depressive disorders.