Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 12, pp 1963–1969 | Cite as

Stressful life events severity in patients with first and recurrent depressive episodes

  • M. RocaEmail author
  • M. Gili
  • J. Garcia-Campayo
  • S. Armengol
  • N. Bauza
  • M. García-Toro
Original Paper



Stressful life events are associated with depression and their role in first onset and recurrences is a promising but controversial perspective of research. The objective is to analyze the role of number of previous episodes and life events exposure in a large sample of primary care depressive patients taking into account life events severity.


10,257 patients with DSM-IV criteria for a current single or recurrent major depressive episode were recruited by 2,056 general practitioners in a cross-sectional epidemiological study. Patients answered the Montgomery-Asberg Depression Rating Scale, the Patient Health Questionnaire and the Social Readjustment Rating Scale (SRRS). Stressful life events were categorized into three levels of severity (severe, moderate and mild). All relevant confounding variables were analyzed: age, gender, depression severity, somatic symptoms severity and length of episode.


We found a significant positive correlation with number of episodes and depression severity. There was no significant correlation of SRRS scores with age, gender and length of episode. ANOVA exploring life events severity with regard to number of episodes showed statistically differences in SRRS total score, moderate life events and mild life events (F = 15.14, p < 0.001) but not for severe life events.


Prevention and treatment strategies for recurrent depression need to manage life stressful events during mild and long-term periods and not just in the initial recurrences of the disease.


Depression Life change events Mood disorders Primary health care Epidemiology 



We thank all the Spanish general practitioners who participated in data collection.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • M. Roca
    • 1
    • 2
    Email author
  • M. Gili
    • 1
    • 2
  • J. Garcia-Campayo
    • 2
    • 3
  • S. Armengol
    • 4
  • N. Bauza
    • 1
    • 2
  • M. García-Toro
    • 1
    • 2
  1. 1.Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), University of Balearic IslandsPalma de MallorcaSpain
  2. 2.Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP)BarcelonaSpain
  3. 3.Department of Psychiatry, Miguel Servet HospitalUniversity of ZaragozaZaragozaSpain
  4. 4.Almirall Medical DepartmentBarcelonaSpain

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