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Clinical and Psychosocial Origins of Chronic Depressive Episodes: II: A Patient Enquiry

  • George W. Brown (a1), P. Moran (a1), T. O. Harris (a1), C. Hepworth (a2) and R. Robinson (a1)...

Abstract

Background

We consider how well the psychosocial and clinical factors found to predict a chronic course for depressive episodes in the community, held for female psychiatric patients.

Method

A consecutive series of depressed patients, aged 18 to 60, treated as in-patients, out-patients or day-patients at psychiatric departments of two London hospitals, were interviewed initially and at follow-up two years later.

Results

Indices of childhood adversity and current interpersonal difficulties predicted episodes taking a chronic course (of more than 12 months' duration). Half of the episodes associated with one or the other factor were chronic, compared with 22% of those with neither. The patients were at higher risk than the community series (75% v. 34%) and this explains their much greater rate of chronicity. There was also some evidence that social support reduced risk. Clinical features and the presence of a personality disorder were unrelated to chronicity.

Conclusions

Similar psychosocial factors are important for predicting chronicity in both community and patient series.

Copyright

Corresponding author

Professor George Brown, Department of Social Policy and Social Science, Royal Holloway College, University of London, 11 Bedford Square, London WC1B 3RA

References

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Clinical and Psychosocial Origins of Chronic Depressive Episodes: II: A Patient Enquiry

  • George W. Brown (a1), P. Moran (a1), T. O. Harris (a1), C. Hepworth (a2) and R. Robinson (a1)...
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