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Social Factors and Comorbidity of Depressive and Anxiety Disorders

Published online by Cambridge University Press:  06 August 2018

G.W. Brown ,
T. O. Harris  and
M. J. Eales
G.W. Brown*
Affiliation:
Royal Holloway, University of London
T. O. Harris
Affiliation:
Royal Holloway, University of London
M. J. Eales
Affiliation:
Tone Vale Hospital, Norton Fitzwarren, Somerset, UK
*
Professor Brown, Department of Social Policy and Social Science, Royal Holloway, University of London, 11 Bedford Square, London WC1B 3RA
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Abstract

Differences in rates of depression across and between populations can be considerable and are largely determined by psychosocial factors. Such findings have important implications for comorbidity. On the basis of multiplying independent probabilities, the proportion of comorbid conditions increases as base rates of the disorders increase in a population. If such a chance combination has clinical implications, it would appear to be a “fact” of significance irrespective of biological underpinnings. In a recent survey of 404 women living with at least one child in an inner-city area, the rate of both anxiety and depression was highly related to the childhood experiences of neglect and abuse. However, adversity in adult life (e.g. widowhood or divorce), which might be expected to relate to current stressors, was only related to the rate of depression. The two risk factors had a considerable impact on comorbidity by increasing the rate of each disorder and thus the probability of their occurring together. They had a lesser impact as “common antecedents”. If both influences are considered, such adversity explains around half of the comorbidity. This is a conservative estimate of the impact of psychosocial factors.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 50 - 57
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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