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Psychiatric disorder in a rural and an urban population: 3. Social integration and the morphology of affective disorder

Published online by Cambridge University Press:  09 July 2009

R. Prudo ,
T. Harris  and
G. W. Brown
R. Prudo*
Affiliation:
Department of Sociology, Bedford College, London
T. Harris
Affiliation:
Department of Sociology, Bedford College, London
G. W. Brown
Affiliation:
Department of Sociology, Bedford College, London
*
1Address for correspondence: Dr R. Prudo, Department of Psychiatry, McMaster University Medical Center, Hamilton, Ontario, Canada.
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Synopsis

This paper focuses on the morphology of affective disorder. We set out to confirm on the island of Lewis a cross-over result originally found on the island of North Uist, whereby in those sections of the population where the rates of depression were lowest the rates of anxiety were highest. These sections of the population varied in the degree to which their members were integrated into the traditional way of life. ‘Integration’ was characterized in terms of churchgoing and crofting (the word for farming in the Hebrides). It is predicted here that the churchgoing rather than the crofting component of the integration measure would account for any cross-over result found concerning the morphology of symptoms. This hypothesis, derived from a theoretical concern with links between repression and anxiety, is not confirmed. Instead, crofting is found to be the component of the integration index which predicts anxiety/phobia without depression. In seeking to explain this unexpected finding further significant associations between crofting, pure anxiety/phobia and the style of personal relationships are revealed. It is also confirmed that types of severe events among women are also found to vary with the degree of integration into traditional society. A perspective is then developed which might explain how the interaction between style of personal attachments and types of provoking event could produce variations in the morphology of affective disorder.

Type
Research Article
Information
Psychological Medicine , Volume 14 , Issue 2 , May 1984 , pp. 327 - 345
Copyright
Copyright © Cambridge University Press 1984

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References

Arieti, S. & Bemporad, J. (1978). Severe and Mild Depression. Basic Books: New York.Google Scholar
Bowker, J. (1973). The Sense of God. Sociological, Anthropological and Psychological Approaches to the Origin of the Sense of God. Clarendon Press: Oxford.Google Scholar
Bowlby, J. (1969). Attachment and Loss. Vol. 1: Attachment. Pelican Books: Harmondsworth.Google Scholar
Bowlby, J. (1971). Attachment and Loss. Vol. 2: Separation: Anxiety and Anger. Pelican Books: Harmondsworth.Google Scholar
Brown, G. W. & Harris, T. (1978). Social Origins of Depression: A Study of Psychiatric Disorder in Women. Tavistock: London.Google Scholar
Brown, G. W. & Prudo, R. (1981). Psychiatric disorder in a rural and an urban population: 1. Aetiology and depression. Psychological Medicine 11, 581–599.Google Scholar
Brown, G. W., Davidson, S., Harris, T., Maclean, U., Pollock, S. & Prudo, R. (1977 a). Psychiatric disorder in London and North Uist. Social Science and Medicine 11, 367–377.Google Scholar
Brown, G. W., Harris, T. & Copeland, J. (1977 b) Depression and loss. British Journal of Psychiatry 130, 1–18.Google Scholar
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983). Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry 142, 247–256.CrossRefGoogle Scholar
Derogatis, L. R., Klerman, G. I. & Lipman, R. S. (1972). Anxiety states and depressive neuroses. Journal of Nervous and Mental Disease 155, 392–403.CrossRefGoogle ScholarPubMed
Durkheim, E. (1915). Suicide. Routledge & Kegan Paul: London.Google Scholar
Evans, P. & Liggett, J. (1971). Loss and bereavement as factors in agoraphobia: implications for therapy. British Journal of Medical Psychology 44, 149–154.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 56–73.Google Scholar
Fenichel, O. (1945). The Psychoanalytic Theory of Neurosis. W. W. Norton: New York.Google Scholar
Fienberg, S. E. (1981). The Analysis of Cross-Classified Categorical Data. MIT Press: Cambridge, Mass.Google Scholar
Finlay-Jones, R. & Brown, G. W. (1981). Types of stressful life events and the onset of anxiety and depressive disorder. Psychological Medicine 11, 803–815.Google Scholar
Finlay-Jones, R., Brown, G. W., Duncan-Jones, P., Harris, T., Murphy, E. & Prudo, R. (1980). Depression and anxiety in the community: replicating the diagnosis of a case. Psychological Medicine 10, 445–454.Google Scholar
Fleiss, J. L. (1981). Statistical Methods for Rates and Proportions (2nd edn). John Wiley & Sons: New York.Google Scholar
Frances, A. & Dunn, P. (1975). The attachment–autonomy conflict in agoraphobia. International Journal of Psychoanalysis 56, 435–439.Google Scholar
Hallam, R. S. (1978). Agoraphobia: A critical review of the concept. British Journal of Psychiatry 133, 314–319.Google Scholar
Klein, D. F. (1964). Delineation of two drug-responsive anxiety syndromes. Psychopharmacologia 5, 397–408.Google Scholar
Klein, D. F. (1981). Anxiety reconceptualized. In Anxiety: New Research and Changing Concepts (ed. Klein, D. F. and Rabkin, J.), pp. 235–263. Raven Press: New York.Google Scholar
Leighton, D. C., Harding, J. S., Macklin, D. B., Hughes, C. C. & Leighton, A. H. (1963). Psychiatric findings of the Stirling County Study. American Journal of Psychiatry 119, 1021–1026.CrossRefGoogle Scholar
Liebowitz, M. R. & Klein, D. F. (1979). Assessment and treatment of phobic anxiety. Journal of Clinical Psychiatry 40, 486–492.Google Scholar
Marks, I. M. (1969). Fears and Phobias. Academic Press: London.Google Scholar
Marks, I. M. (1979). Cure and care of neurosis. Psychological Medicine 9, 629–660.Google Scholar
Mol, J. J. (1976). Identity and the Sacred. Blackwell: London.Google Scholar
Parkes, C. M. (1969). Broken heart: A statistical study of increased mortality among widowers. British Medical Journal i, 740–743.Google Scholar
Prudo, R., Brown, G. W., Harris, T. & Dowland, J. (1981). Psychiatric disorder in a rural and an urban population: 2. Sensitivity to loss. Psychological Medicine 11, 601–616.Google Scholar
Radcliffe-Brown, A. R. (1952). Taboo. In Structure and Function in Primitive Society. Cohen and West: London. (Originally published 1939.)Google Scholar
Rohs, R. G. & Noyes, R. (1978). Agoraphobia: Newer treatment approaches. Journal of Nervous and Mental Disease 166, 701–708.CrossRefGoogle ScholarPubMed
Roth, M. (1959). The phobic–anxiety–depersonalization syndrome. Proceedings of the Royal Society of Medicine 52, 587–595.Google Scholar
Roth, M., Gurney, C., Garside, R. F. & Kerr, T. A. (1972). Studies in the classification of affective disorders. British Journal of Psychiatry 121, 147–161.Google Scholar
Rutter, M. & Quinton, D. (1977). Psychiatric disorder – ecological factors and concepts of causation. In Ecological Factors in Human Development (ed. McGurk, H.), pp. 173–187. North-Holland: Amsterdam.Google Scholar
Schapira, K., Kerr, T. A. & Roth, M. A. (1970). Phobias and affective illness. British Journal of Psychiatry 117, 25–32.CrossRefGoogle ScholarPubMed
Snaith, R. P. (1968). A clinical investigation of phobias. British Journal of Psychiatry 114, 673–697.CrossRefGoogle ScholarPubMed
Solyom, L., Silberfeld, M. & Solyom, C. (1976). Maternal overprotection in the etiology of agoraphobia. Canadian Psychiatric Association Journal 21, 109–113.Google Scholar
Wing, J. K. & Sturt, E. (1978). The PSE–ID–CATEGO System: A Supplementary Manual. Institute of Psychiatry: London.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wing, J. K., Nixon, J. M., Mann, S. A. & Leff, J. P. (1977). Reliability of the PSE (ninth edition) used in a population study. Psychological Medicine 7, 505–516.CrossRefGoogle ScholarPubMed
Wing, J. K., Mann, S. A.Leff, J. P. & Nixon, J. M. (1978). The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine 8, 203–217.Google Scholar