Hostname: page-component-7c8c6479df-5xszh Total loading time: 0 Render date: 2024-03-28T19:27:46.231Z Has data issue: false hasContentIssue false

Acontecimientos vitales y cambios en el curso de la depresión en adultos jóvenes

Published online by Cambridge University Press:  12 May 2020

Robert H. Friis
Affiliation:
Departamento de Ciencia de la Salud, Universidad del Estado de California, Long Beach, CA, EE.UU
Hans-UIrich Wittchen
Affiliation:
Instituto Max Planck de Psiquiatría, Psicología Clínica y Epidemiología, Kraepelinstrasse 2, 80804, Munich, Alemania Departamento de Psicología Clínica y Psicoterapia, Universidad Técnica de Dresde, Dresde, Alemania
Hildegard Pfister
Affiliation:
Instituto Max Planck de Psiquiatría, Psicología Clínica y Epidemiología, Kraepelinstrasse 2, 80804, Munich, Alemania
Roselind Lieb
Affiliation:
Instituto Max Planck de Psiquiatría, Psicología Clínica y Epidemiología, Kraepelinstrasse 2, 80804, Munich, Alemania
Get access

Resumen

Antecedentes:

Pocos estudios comunitarios han examinado las repercusiones de los acontecimientos vitales, las condiciones de vida y los cambios vitales en el curso de la depresión. Este artículo examina las asociaciones de los acontecimientos vitales en el comienzo, la mejoría y la estabilidad de los síntomas depresivos.

Métodos:

Se utilizan datos directos de la entrevista con el Estudio de los Estadios Evolutivos Tempranos de las Manifestaciones Psicopatológicas (EDSP), un diseño prospectivo longitudinal de 4-5 años basado en una muestra comunitaria representativa de adolescentes y adultos jóvenes con 14-24 años en la línea de base. Los acontecimientos vitales se midieron utilizando el Cuestionario de Acontecimientos de Munich (MEL), que consta de 83 elementos explícitos de diversas áreas de rol social y subescalas para la evaluación de grupos de acontecimientos vitales clasificados según dimensiones como positivo y negativo y controlable e incontrolable. Los trastornos depresivos se evaluaron con la versión del DSM-IV de la Entrevista Diagnóstica Compuesta de Munich (M-CIDI). Análisis de regresión logística múltiple examinaron los efectos de 22 predictores en el curso (el comienzo, la mejoría y la estabilidad) de la depresión.

Resultados:

Una menor edad, la clase social baja y los acontecimientos vitales negativos y cargados de estrés relacionados con la familia se asociaban con un aumento del riesgo de depresión de nuevo comienzo. La ansiedad era un predictor independiente significativo de la depresión de nuevo comienzo. La ausencia de acontecimientos escolares y familiares cargados de estrés se relacionaba con la mejoría en la depresión. El número total ponderado de acontecimientos vitales predecía depresión estable.

Conclusiones:

La asociación entre los acontecimientos vitales y el curso de la depresión parece variar según la respuesta clínica que se examina, prediciendo diferencialmente distintos grupos de acontecimientos vitales el comienzo, la mejoría y la estabilidad.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Ferguson, E, Lawrence, C, Matthews, G. Associations between primary appraisal and life-events while controlling for depression. Br J Clin Psychol 2000; 39: 143–55.CrossRefGoogle Scholar
Butow, PN, Hiller, JE, Price, MA, Thackway, SV, Kricker, A, Tennant, CC. Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cáncer. J Psychosomatic Res 2000; 49 (3): 169–81.CrossRefGoogle ScholarPubMed
Leserman, J, Petitto, JM, Golden, RN, Gaynes, BN, Gu, HB, Perkins, DO, et, al. Impact of stressful life events, social support, coping, and cortisol on progression to AIDS. Am J Psychiatry 2000; 157(8): 1221–8.CrossRefGoogle ScholarPubMed
Peterson, MGE, Allegrante, JP, Augurt, A, Robbins, L, MacKenzie, CR, Cornell, CN. Major life events as antecedents to hip fracture. J Trauma-Injury Infect Crit Care 2000; 48(6): 1096–100.CrossRefGoogle ScholarPubMed
Brown, GW, Harris, TO. Social origins of depression: a study of psychiatry disorder in women. New York: Free Press; 1978.Google Scholar
Kendler, KS, Kessler, RC, Walters, EE, MacLean, C, Neale, MC, Heath, AC, et, al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry 1995; 152: 833–42.Google ScholarPubMed
Billings, A, Cronkite, R, Moos, R, Social environment factors in unipolar depression: comparisons of depressed patients and nondepressed Controls. J Abnormal Psychol 1983; 93: 119–33.CrossRefGoogle Scholar
Blazer, D, Hughes, D, George, LK. Stressful life events and the onset of a generalized anxiety syndrome. Am J Psychiatry 1987; 144: 1178–85.Google ScholarPubMed
Murphy, DA, Moscicki, AB, Vermund, SH, Muenz, LR. Psychological distress among HIV+ adolescents in the REACH study: effects of life stress, social support, and coping. J Adoles Health 2000; 27(6): 391–8.CrossRefGoogle ScholarPubMed
Kessler, RC. The effects of stressful life events on depression. Ann Rev Psychol 1997; 48: 191214.CrossRefGoogle ScholarPubMed
Wittchen, HU. Chronic difficulties and life events in the longterm course of affective and anxiety disorders.’ results from the Munich-follow-up study. In: Angermeyer, MC, editor. From social class to social stress - New developments in psychiatric epidemiology. Berlín: Springer; 1987. p. 176–96.CrossRefGoogle Scholar
Mundt, C, Reck, C, Backenstrass, M, Kronmuller, K, Fiedler, P. Reconfirming the role of life events for the timing of depressive episodes. A two-year prospective follow-up study. J Affect Disorders 2000; 59(1): 2330.CrossRefGoogle ScholarPubMed
Holmes, TH, Rahe, RH. The social adjustment scale. J Psychosomatic Res 1967; 11: 213–8.CrossRefGoogle Scholar
Paykel, ES. Life events, social support and depression. Acta Psychiatrica Scandinavica 1994; 377(Suppl) :50–8.CrossRefGoogle ScholarPubMed
Bifulco, A, Bernazzani, O. Moran, PM, Ball, C. Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI). Social Psychiatry and Psychiatric Epidemiology 2000; 35(6): 264–75.CrossRefGoogle Scholar
Brown, GW, Bifulco, A, Harris, TO. Life events, vulnerability and onset of depression: some refinements. Br J Psychiatry 1987; 150: 3042.CrossRefGoogle ScholarPubMed
Goodyer, IM, Herbert, J, Pamplin, A, Altham, PME. Firstepisode major depression in adolescents. Affective, cognitive and endocrine characteristics of risk status and predictors of onset. Br J Psychiatry 2000; 176: 142–9.CrossRefGoogle Scholar
Eley, TC, Stevenson, J. Specific life events and chronic experiences differentially associated with depression and anxiety in young twins. J Abnormal Child Psychol 2000; 28: 383–94.CrossRefGoogle ScholarPubMed
Shrout, PE, Link, B, Dohrenwend, B, Skodol, AE. Characterizing life events as risk factors for depression: the role of fateful loss events. T Abnormal Psychol 1989; 98: 460–7.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski, LM, Prescott, CA. Stressful life events and major depression: risk period, long-term contextual threat, and diagnostic specificity. Journal of Nervous Mental Disease 1998; 186: 661–9.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski, LM, Prescott, CA. Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 1999; 156: 837–41.CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski-Shuman, L. Stressful life events and genetic liability to major depression: genetic control of exposure to the environment? Psychological Med 1997;27:539–47.CrossRefGoogle ScholarPubMed
Farmer, A, Harris, T. Redman, K, Sadler, S. Mahmood, A, McGuffin, P. Cardiff depression study. A sib-pair study of life events and familiarity in major depression. Br J Psychiatry 2000; 176: 150–5.CrossRefGoogle Scholar
Faravelli, C, Sacchetti, E, Ambonetti, A, Conte, G, Pallanti, S, Vita, A. Early life events and affective disorder revisited. Br J Psychiatry 1986; 148: 288–95.CrossRefGoogle ScholarPubMed
Kendler, KS, Thornton, LM, Gardner, CO. Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the “kindling” hypothesis. Am J Psychiatry 2000; 157(8): 1243–51.CrossRefGoogle ScholarPubMed
Holahan, C, Moos, R. Life stressors, personal and social resources, and depression: a 4-year structural model. J Abnormal Psychol 1991; 100: 31–8.CrossRefGoogle ScholarPubMed
Maciejewski, PK, Prigerson, HG, Mazure, CM. Self-efficacy as a mediator between stressful life events and depressive symptoms. Differences based on history of prior depression. Br J Psychiatry 2000; 176: 373–8.CrossRefGoogle ScholarPubMed
Wade, TD, Kendler, KS. Absence of interactions between social support and stressful life events in the prediction of major depression and depressive symptomatology in women. Psychological Med 2000; 30: 965–74.CrossRefGoogle ScholarPubMed
Kessler, RC, Kendler, KS, Heath, A, Neale, MC, Eaves, LJ. Social support, depressed mood, and adjustment to stress a genetic epidemiologic investigation. J Personality Social Psychol 1992; 62: 257–72.CrossRefGoogle ScholarPubMed
Wittchen, HU, Perkonigg, A, Lachner, G, Nelson, CB. Early developmental stages of psychopathology study (EDSP): objectives and design. Eur Addiction Res 1998; 4(1-2): 1827.CrossRefGoogle ScholarPubMed
Lieb, R, Isensee, B, Sydow, Kvon, Wittchen, HU. The early developmental stages of psychopathology study (EDSP): a methodological update. Eur Addiction Res 2000; 6: 170–82.CrossRefGoogle ScholarPubMed
Wittchen, HU, Nelson, GB, Lachner, G. Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Med 1998; 28: 109–26.Google ScholarPubMed
Wittchen, HU, Pfister, H, editors. DIA-X-Interviews: Manual fur Screening-Verfahren und Interview, Interviewheft Langsschnittuntersuchung (DIA-X-Lifetime), Erganzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Erganzungsheft (DlA-X-12Monate); PC-Programm zur Durchführung des Interviews (Lángs- und Querschnittuntersuchung); Auswertungsprogram. Frankfurt: Swets Zeitlinger; 1997.Google Scholar
World Health Organisation. Composite International Diagnostic Interview (CIDI): (a) CIDI-interview (versión 1.0), (b) CIDI-user manual, (c) CIDI-training manual (d) CIDI-computer programs. Geneva: World Health Organisation; 1990.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington DC: APA; 1994.Google Scholar
World Health Organization. ICD-10, Chapter V, Mental and Behavioral Disorders (including disorders of psychological development). Diagnostic Criteria for Research. Draft for Field Triáis. Geneva: World Health Organization, 1991.Google Scholar
Wittchen, HU, Lieb, R, Schuster, P, Oldehinkel, T. When is onset? Investigations into early developmental stages of anxiety and depressive disorders. In: Rapoport, JL, editor. Childhood onset of “adult” psychopathology, clinical and research advances. Washington: American Psychiatric Press; 1999. p. 259302.Google Scholar
Hofler, M, Lieb, R, Perkonigg, A, Schuster, P, Sonntag, H, Wittchen, HU. Covariates of cannabis use progression in a representative population sample of adolescents: a prospective examination of vulnerability and risk factors. Addiction 1999; 94(11): 1679–94.CrossRefGoogle Scholar
Lachner, G. Wittchen, HU, Perkonigg, A, Holly, A, Schuster, P. Wunderlich, U, et, al. Structure, content and reliability of the Munich-Composite International Diagnostic Interview (M-CIDI). Substance use sections. European Addiction Research 1998, 4(1-2): 2841.CrossRefGoogle ScholarPubMed
Reed, V, Gander, F, Pfister, H, Steiger, A, Sonntag, H, Trenkwalder, C, et, al. To what degree the Composite International Diagnostic Interview (CIDI) correctly identifies DSM-IV disorders? Testing validity issues in a clinical sample. Int J Meth Psychiatric Res 1998; 7(3): 142–55.Google Scholar
Wittchen, HU, Lachner, G, Wunderlich, U, Pfister, H. Testretestreliability of the computerized DSM-IV versión of the Munich-Composite International Diagnostic Interview (M-CIDI). Social Psychiatry and Psychiatric Epidemiology 1998; 33: 568–78.CrossRefGoogle Scholar
Oldehinkel, A, Wittchen, HU, Schuster, P. Prevalence, 20- month incidence and outcome of unipolar depressive disorders in a community sample of adolescents. Psychological Med 1999; 29: 655–68.CrossRefGoogle Scholar
Dehmel, S. Wittchen, HU. Anmerkungen zur retrospektiven Erfassung von Lebensereignissen und Lebensbedingungen bei Verlaufsuntersuchungen - Bewertung und Vergessen -. Zeitschrift fur Klinische Psychologie 1984; 13: 88110.Google Scholar
StataCorp. Stata statistical software: Release 6.0. College Station, TX: Stata Corporation; 1999.Google Scholar
Royall, RM. Model robust confidence intervals using máximum likelihood estimators. Int Stat Rev 1986; 54: 221–6.Google Scholar
Mathiesen, KS, Tambs, K, Dalgard, OS. The influence of Social class, strain and social support on symptoms of anxiety and depression in mothers of toddlers. Social Psychiatry and Psychiatric Epidemiology 1999; 34: 6172.Google ScholarPubMed
Mazure, CM, Bruce, ML, Maciejewski, PK, Jacobs, SC. Adverse life events and cognitive-personality characteristics in the prediction of major depression and antidepressant response. Am J Psychiatry 2000; 157(6): 896903.CrossRefGoogle ScholarPubMed
Prigerson, HG, Reynolds, CF, Frank, E, Kupfer, DJ, George, CJ, Houck, PR. Stressful life events, Social rhythms, and depressive symptoms among the elderly. An examination of hypothesized causal linkages. Psychiatry Res 1994; 51(1): 3349.CrossRefGoogle ScholarPubMed
Lewinsohn, PM, Rohde, P, Seeley, JR, Klein, DN, Gotlib, LH. Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults. Am J Psychiatry 2000; 157(10): 1584–91.CrossRefGoogle Scholar
Wittchen, HU, Schuster, P. Lieb, R. Comorbidity and mixed anxiety-depressive disorder: clinical curiosity or pathophysiological need? Human Psychopharmacol 2001; 16: 2130.CrossRefGoogle ScholarPubMed