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Disease, distress and depression. A comment.

G W Brown, T Harris

    Journal of Affective Disorders
    |March 1, 1982
    PubMed
    Summary

    Psychiatric disorders are often linked to significant life events, contrary to previous suggestions. A review indicates most patients experience major life events before symptom onset, challenging the distress-only model.

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    Area of Science:

    • Psychiatry
    • Epidemiology
    • Psychological distress

    Background:

    • Previous research suggested psychiatric disorders in the community are primarily distress-related.
    • This assertion was based on limited preceding life events in outpatients.

    Purpose of the Study:

    • To re-evaluate the relationship between life events and psychiatric disorders.
    • To challenge the disease vs. distress dichotomy in psychiatric conditions.

    Main Methods:

    • A review of 7 recent studies on depressive patients was conducted.
    • A comparable life-event instrument was used across studies.
    • Findings were compared to population-based data.

    Main Results:

    • An average of 56% of depressive patients experienced a significant life event before onset.
    • This contrasts with 18% in the general population.
    • The original study's methodology was found to have critical replication failures.

    Conclusions:

    • Psychiatric disorders, particularly depression, are frequently preceded by significant life events.
    • The distinction between disease and distress requires re-examination in light of empirical findings.
    • Community psychiatric disorders are not solely explained by distress.

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