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

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Abstract

Background

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.

Method

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.

Results

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.

Conclusions

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.

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Acknowledgments

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

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Authors and Affiliations

  1. Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07071, Palma de Mallorca, Spain

    M. Roca, M. Gili, N. Bauza & M. García-Toro

  2. Red de Actividades Preventivas y Promoción de la Salud en Atención Primaria (RediAPP), Barcelona, Spain

    M. Roca, M. Gili, J. Garcia-Campayo, N. Bauza & M. García-Toro

  3. Department of Psychiatry, Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain

    J. Garcia-Campayo

  4. Almirall Medical Department, Barcelona, Spain

    S. Armengol

Authors
  1. M. Roca
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  2. M. Gili
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  3. J. Garcia-Campayo
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  4. S. Armengol
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  5. N. Bauza
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  6. M. García-Toro
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Correspondence to M. Roca.

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Roca, M., Gili, M., Garcia-Campayo, J. et al. Stressful life events severity in patients with first and recurrent depressive episodes. Soc Psychiatry Psychiatr Epidemiol 48, 1963–1969 (2013). https://doi.org/10.1007/s00127-013-0691-1

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  • DOI: https://doi.org/10.1007/s00127-013-0691-1

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