Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-16T00:42:56.872Z Has data issue: false hasContentIssue false
  • English
  • Français

The Camberwell Collaborative Depression Study I. Depressed Probands: Adversity and the Form of Depression

Published online by Cambridge University Press:  02 January 2018

P. E. Bebbington ,
T. Brugha ,
B. MacCarthy ,
J. Potter ,
E. Sturt ,
T. Wykes ,
R. Katz  and
P. McGuffin
P. E. Bebbington*
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry
T. Brugha
Affiliation:
Department of Psychiatry, University of Leicester
B. MacCarthy
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry
J. Potter
Affiliation:
Cassel Hospital, Richmond
T. Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry
R. Katz
Affiliation:
Genetics Unit, Institute of Psychiatry
P. McGuffin
Affiliation:
University of Wales College of Medicine
*
∗De Crespigny Park, Denmark Hill, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

The Camberwell Collaborative Depression Study is an investigation of a series of 130 patients (76 female; 54 male) attending the Maudsley Hospital Services with unipolar depression of recent onset (the probands), and of their first-degree relatives. This paper describes the first element of the study, the investigation of the index cases or probands, which was carried out by members of the MRC Social Psychiatry Unit over the period 1982–1985. A description of the methods of the study is followed by an analysis of life events in relation to the symptomatic pattern of the depressive state. An ‘endogenous' group was defined as cases of depression falling within Catego classes D and R, and compared with a ‘neurotic’ group conforming to classes N and A. The hypothesis that the ‘endogenous' group of disorders would be relatively independent of prior life stress was not confirmed. Depressed women were more likely to have experienced life events or difficulties than their male counterparts, and there was some evidence that sex, but not age or social class, influenced the relationship between adversity and the type of depression. Examination of the timing of life events was strongly suggestive of a causal effect, with a pronounced rise in the month before onset. This was not limited to the most severe events. Differences between the ‘endogenous' and ‘neurotic’ groups in the temporal patterning of events before onset are discussed. The findings are interpreted in terms of the literature on the topic.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 152 , Issue 6 , June 1988 , pp. 754 - 765
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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

Bebbington, P. E. (1987) Misery and beyond: the pursuit of disease theories of depression. International Journal of Social Psychiatry, 33, 13–20.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Tennant, C. & Hurry, J. (1981a) Life events and the nature of psychiatric disorder in the community. Journal of Affective Disorders, 3, 345–366.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981b) The epidemiology of mental disorders in Camberwell. Psychological Medicine, 11, 561–580.CrossRefGoogle ScholarPubMed
Benjaminsen, S. (1981) Primary non-endogenous depression and features attributed to reactive depression. Journal of Affective Disorders, 3, 245–259.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. London: Tavistock.Google ScholarPubMed
Brown, G. W. & Harris, T. O., ni Bhrolchain, M. & Harris, T. (1979) Psychotic and neurotic depression – Part 3. Aetiological and background factors. Journal of Affective Disorders, 1, 195–211.CrossRefGoogle ScholarPubMed
Brugha, T., Conroy, R., Walsh, N., Delaney, W., O'Hanlon, J., Dondero, B., Daly, L., Hickey, N. & Bourke, G. (1982) Social networks, attachments and support in minor affective disorders: a replication. British Journal of Psychiatry, 141, 249–255.CrossRefGoogle ScholarPubMed
Brugha, T., Conroy, R., Walsh, N., Delaney, W., O'Hanlon, J., Dondero, B., Daly, L., Hickey, N. & Bourke, G. (1985) Categories of depression: reported life events in a controlled design. British Journal of Psychiatry, 147, 641–646.CrossRefGoogle Scholar
Cadoret, R. J., Winokur, G., Dorzab, J. & Baker, M. (1972) Depressive disease: life events and onset of illness. Archives of General Psychiatry, 26, 133–136.CrossRefGoogle ScholarPubMed
Calloway, S. P., Dolan, R. J., Fonagy, P., De Souza, V. F. A. & Wakeling, A. (1984a) Endocrine changes and clinical profiles in depression: I. The dexamethasone suppression test. Psychological Medicine, 14, 749–758.CrossRefGoogle ScholarPubMed
Calloway, S. P., Dolan, R. J., Fonagy, P., De Souza, V. F. A. & Wakbling, A. (1984b) Endocrine changes and clinical profiles in depression: II. The thyrotropin-releasing hormone test. Psychological Medicine, 14, 759–766.CrossRefGoogle ScholarPubMed
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–674.CrossRefGoogle Scholar
Cooke, D. J. (1981) Life events and syndromes of depression in the general population. Social Psychiatry, 16, 181–186.CrossRefGoogle Scholar
Cornell, D. G., Milden, R. S. & Shimp, S. (1985) Stressful life events associated with endogenous depression. Journal of Nervous and Mental Disease, 173, 470–476.CrossRefGoogle ScholarPubMed
Costello, C. G. (1982) Social factors associated with depression: a retrospective community study. Psychological Medicine, 12, 329–339.CrossRefGoogle ScholarPubMed
Dolan, R. J., Calloway, S. P., Fonagy, P., De Souza, V. F. A. & Wakeling, A. (1985) Life events, depression and hypothalamic-pituitary-adrenal axis function. British Journal of Psychiatry, 147, 429–433.CrossRefGoogle ScholarPubMed
Fava, G. A., Munari, F., Pavan, L. & Kellner, R. (1981) Life events and depression: a replication. Journal of Affective Disorders, 3, 159–165.CrossRefGoogle ScholarPubMed
Feinberg, M. & Carroll, B. J. (1982) Separation of subtypes of depression using discriminant analysis: I. Separation of unipolar endogenous depression from non-endogenous depression. British Journal of Psychiatry, 140, 384–391.CrossRefGoogle ScholarPubMed
Garside, R. F., Kay, D. W. K., Wilson, I. C., Deaton, I. D. & Roth, M. (1971) Depressive syndromes and the classification of patients. Psychological Medicine, 1, 333–338.CrossRefGoogle ScholarPubMed
Goldthorpe, J. & Hope, K. (1974) The Social Grading of Occupations: A New Approach and Scale. London: Oxford University Press.Google Scholar
Griesinger, W. (1861) Die Pathologie und Therapie der Psychischen Krankheiten (2nd edn). Braunschweig: Wreden. Translated (1867) as Mental Pathology and Therapeutics by Robertson, C. L. & Rutherford, J. London: New Sydenham Society.Google Scholar
Haberman, S. J. (1973) The analysis of residuals in cross-classified tables. Biometrics, 29, 205–220.CrossRefGoogle Scholar
Hamilton, M. & White, J. M. (1959) Clinical syndromes in depressive states. Journal of Mental Science, 105, 985–998.CrossRefGoogle ScholarPubMed
Henderson, A. S., Byrne, D. G. & Duncan-Jones, P. (1981) Neurosis and the Social Environment. Sydney: Academic Press.Google Scholar
Hudgens, R. W., Morrison, J. R. & Barchka, R. (1967) Life events and onset of primary affective disorders: a study of 40 hospitalised patients and 40 controls. Archives of General Psychiatry, 16, 134–145.CrossRefGoogle ScholarPubMed
Hurry, J., Tennant, C. & Bebbington, P. E. (1980) Selective factors leading to psychiatric referral. Acta Psychiatrica Scandinavica, Suppl. 285, 315–323.CrossRefGoogle Scholar
Katschnig, H. (1984) Commentary to: Inferring causes: some constraints in the social psychiatry of depressive disorders (P. Bebbington). Integrative Psychiatry, 2, 77–79.Google Scholar
Katschnig, H., Brandl-Nebehay, A., Fuchs-Robetin, G., Seelig, P., Eichberger, G., Strobl, R. & Sint, P. P. (1981) Lebensverän-dernde Ereignisse, Psychoziale Dispositionen und Depressive Verstimmungzustände. Wien: Abteilung Für Sozialpsychiatrie und Dokumentation, Psychiatrische Universitatsklinik.Google Scholar
Katschnig, H., Pakesh, G. & Egger-Zeidner, E. (1986) Life stress and subtypes of depression In Life Events and Psychiatric Disorders: Controversial Issues (ed. Katschnig, H.). Cambridge: Cambridge University Press.Google Scholar
Kay, D. W. K., Garside, R. F., Beamish, P. & Roy, J. R. (1969) Endogenous and neurotic syndromes of depression – a factor analytic study of 104 cases: clinical features. British Journal of Psychiatry, 115, 377–388.CrossRefGoogle ScholarPubMed
Kiloh, L. G. & Garside, R. F. (1963) The independence of neurotic depression and endogenous depression. British Journal of Psychiatry, 109, 451–463.CrossRefGoogle ScholarPubMed
Leff, M. H., Roach, J. F. & Bunney, W. E. (1970) Environmental factors preceding the onsets of severe depressions. Psychiatry, 33, 293–311.CrossRefGoogle ScholarPubMed
McGuffin, P. & Katz, R. (1986) Nature, nurture and affective disorders In The Biology of Depression (ed. Deakin, J. F. W.). London: Gaskill.Google Scholar
Markush, R. E. & Favero, R. V. (1974) Epidemiological assessment of stressful life events, depressed mood and psychophysiological symptoms: a preliminary report In Stressful Life Events: Their Nature and Effects (eds Dohrenwend, B. S. & Dohrenwend, B. P.). New York: John Wiley.Google Scholar
Mendels, J. & Cochrane, C. (1968) The nosology of depression – the endogenous-reactive concept. American Journal of Psychiatry, 124, Suppl. 1–11.CrossRefGoogle ScholarPubMed
Myers, J., Lindenthal, J. & Pepper, M. (1974) Social class, life events and psychiatric symptoms: a longitudinal study In Stressful Life Events: Their Nature and Effects (eds Dohrenwend, B. S. & Dohrenwend, B. P.). New York: John Wiley.Google Scholar
Nelson, C. J. & Charney, D. S. (1980) Primary affective disorder criteria and the endogenous-reactive distinction. Archives of General Psychiatry, 37, 787–793.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1971) Classification of depressed patients: a cluster analysis derived grouping. British Journal of Psychiatry, 118, 275–288.CrossRefGoogle ScholarPubMed
Paykel, E. S., Myers, J. K., Dienelt, M. N., Klerman, G. L., Lindenthal, J. J. & Pepper, M. P. (1969) Life events and depression: a controlled study. Archives of General Psychiatry, 21, 753–760.CrossRefGoogle ScholarPubMed
Paykel, E. S., Rao, B. M. & Taylor, C. N. (1984) Life stress and symptom pattern in out-patient depression. Psychological Medicine, 14, 559–568.CrossRefGoogle ScholarPubMed
Perris, C., Perris, M., Ericsson, U. & von Knorring, L. (1982) The genetics of depression: a family study of unipolar and neurotic-reactive depressed patients. Archiv für Psychiatrie und Nervenkrankheit, 232, 137–155.CrossRefGoogle ScholarPubMed
Pollitt, J. (1972) The relationship between genetic and precipitating factors in depressive illness. British Journal of Psychiatry, 121, 67–70.CrossRefGoogle ScholarPubMed
Reich, T., Cloninoer, C. R., Suarez, B. & Rice, J. (1982) Genetics of the affective psychoses In Handbook of Psychiatry, Vol. III: Psychosis of Uncertain Aetiology (eds Wing, J. K. & Wing, L.). Cambridge: Cambridge University Press.Google Scholar
Rosenthal, S. H. & Klerman, G. L. (1966) Content and consistency in the endogenous depressive pattern. British Journal of Psychiatry, 112, 471–484.CrossRefGoogle Scholar
Rosenthal, S. H. & Gudeman, J. E. (1967) The endogenous depressive pattern. Archives of General Psychiatry, 16, 241–249.CrossRefGoogle ScholarPubMed
Roy, A., Breier, A., Doran, A. R. & Pickar, D. (1985) Life events and depression: relation to subtypes. Journal of Affective Disorders, 9, 143–148.CrossRefGoogle Scholar
Sturt, E., Bebbington, P. E., Hurry, J. & Tennant, C. (1981) The Present State Examination used by interveiwers from a survey agency: report from the Camberwell Community Survey. Psychological Medicine, 11, 185–192.CrossRefGoogle ScholarPubMed
Surtees, P. G., Miller, P.McC., Ingham, J. G., Kreitman, N. B., Rennie, D. & Sashidharan, S. P. (1986) Life events and the onset of affective disorder: a longitudinal general population study. Journal of Affective Disorder, 10, 37–50.CrossRefGoogle ScholarPubMed
Thase, M. E., Frank, E. & Kupfer, D. J. (1985) Biological processes in major depression In Depression: Treatment, Assessment and Research (eds Beckham, E. E. & Leber, W. R.). Home wood, Ill: Dorsey Press.Google Scholar
Thompson, K. C. & Hendrie, H. C. (1972) Environmental stress in primary depressive illness. Archives of General Psychiatry, 26, 130–132.CrossRefGoogle Scholar
Wing, J. K. (1983) Use and misuse of the PSE. British Journal of Psychiatry, 143, 111–117.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sturt, E. (1978) The PSE-ID-CATEGO System: a Supplementary Manual (mimeo). London: Institute of Psychiatry.Google Scholar
Wing, J. K., Bebbington, P., Hurry, J. & Tennant, C. (1981) The prevalence in the general population of disorders familiar to psychiatrists in hospital practice In What is a Case? (eds Wing, J. K., Bebbington, P. & Robins, L. N.). London: Grant Maclntyre.Google Scholar
Wing, J. K., Bebbington, P., Hurry, J. & Tennant, C. (1985) The epidemiology of depression In Depression: Treatment, Assessment and Research (eds Beckham, E. E. & Leber, W. R. Homewood, Ill: Dorsey Press.Google Scholar
World Health Organization (1974) Glossary of Mental Disorders and Guide to their Classification, for Use in Conjunction with the International Classification of Diseases, 8th Revision. Geneva: WHO.Google Scholar
Zimmerman, M., Coryell, W., Pfohl, B. & Stangel, D. (1986a) The validity of four definitions of endogenous depression: II. Clinical, demographiC., familial and psychosocial correlates. Archives of General Psychiatry, 43, 234–244.CrossRefGoogle ScholarPubMed
Zimmerman, M., Coryell, W., Pfohl, B. & Stangel, D. (1986b) The validity of the dexamethasone suppression test as a marker for endogenous depression. Archives of General Psychiatry, 43, 347–355.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.