Life stress, chronic subclinical symptoms and vulnerability to clinical depression

Prospective enquiries of the role of social factors in the aetiology of depression are faced with the problem of who to exclude from the enquiry in terms of psychiatric symptomatology present at first contact. With this problem in mind the role of subclinical symptoms among women not cases of depression has been examined in terms of their relation with a subsequent onset of caseness depression. Psychosocial factors of particular importance in the development of such depression were low self-esteem, marked long-term difficulties and severe life events arising out of (or 'matching') these difficulties. These psychosocial factors were also correlated with the presence of subclinical symptoms. It is concluded that although subclinical symptoms relate to a raised risk of subsequent depression at a caseness level there is no evidence that there is inherent vulnerability stemming from such subclinical symptoms over and above that explained by the psychosocial correlates.