Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-30T16:14:43.736Z Has data issue: false hasContentIssue false
  • English
  • Français

Environmental Factors in Depressive Illness

Published online by Cambridge University Press:  29 January 2018

A. D. Forrest ,
R. H. Fraser  and
R. G. Priest
A. D. Forrest
Affiliation:
Royal Edinburgh Hospital, Morning side, and Department of Psychiatry, University of Edinburgh
R. G. Priest
Affiliation:
Royal Edinburgh Hospital, Morning side, and Department of Psychiatry, University of Edinburgh
Get access Rights & Permissions [Opens in a new window]

Extract

There seems to be a series of conceptual problems regarding depressive illness and its classification. First, there is the problem of whether these illnesses have some biological function, whether they represent attempts on the part of human organisms to deal with or escape from situations of stress, or whether they should be thought of simply as psychologically meaningless events. Eysenck (1960) and Wolpe (1958) make it clear that they regard neurotic symptoms as meaningless, maladaptive patterns which can and should be removed by suggestion, deconditioning and behaviour therapy. Similarly, Mayer-Gross, Slater and Roth (1955) reject the suggestion that depressive illness may have an adaptive function. By contrast, clinical medicine, though resting heavily on the mechanistic causality models of physics and chemistry, does give some implicit recognition of biological purpose in physical illness. Thus, pneumonia represents not only the phenomenon of invasion of pulmonary tissue by infective agents, but also the phenomenon of bodily defence against such invasion. When such defence does not exist, the patient seldom gets to the physician in time to be diagnosed. That depressive illness might have an analogous biological function was suggested by Freud (1917) and elaborated in impressive detail by Lewis (1934). The converse view that depressive illness represents a breakdown in adaptive function is based on the views of Kraepelin (1913) who attributed the dominant place in the depressive group of illnesses to manic-depressive psychosis with its known hereditary basis. That hereditary factors do operate in the manic-depressive group proper seems to have been demonstrated more than adequately by Slater (1938) and Kallmann (1950). The evidence regarding other depressive reactions, whether recurrent or involutional, seems far from impressive. Nevertheless, Mayer-Gross et al. take the view that affective illness is primarily a question of constitution, that the content of the depression may be understandable in terms of the patient's life situation, but that the causes of breakdown given by relatives of patients are really symptoms of the oncoming illness. Interestingly enough, Henderson and Gillespie (1956) classify affective illness into manic-depressive and involutional depression, and note the importance of social factors (p. 276).

Type
Research Article
Information
The British Journal of Psychiatry , Volume 111 , Issue 472 , March 1965 , pp. 243 - 253
Copyright
Copyright © Royal College of Psychiatrists, 1965 

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

Affleck, J. W., Forrest, A. D., and Martin, F. M. (1961). “Adjunctive therapy in depression: a controlled trial of nialamide.” J. Ment. Sci., 107, 997.Google Scholar
Bowlby, J. (1961). “Childhood mourning and its implication for psychiatry.” Amer. J. Psychiat., 118, 481.CrossRefGoogle ScholarPubMed
Brown, F. (1961). “Depression and childhood bereavement.” J. Ment. Sci., 107, 754.Google Scholar
Curran, D. (1937). “The differentiation of neuroses and manic-depressive psychoses.” Ibid., 83, 191.Google Scholar
Eysenck, H. J. (1960). Behaviour Therapy and the Neuroses. London: Pergamon.Google Scholar
Forrest, A. D., and Horne, P. M. (1962). “Pilot trial of I.C.I. 31397 a new mono-amine oxidase inhibitor.” Scot. Med. J., 7, 224.Google Scholar
Fox, H. (1942). “Dynamic factors in the affective psychoses.” Amer. J. Psychiat., 98, 684.CrossRefGoogle Scholar
Freud, S. (1956). “Mourning and melancholia”, in Collected Papers, 4. London: Hogarth Press.Google Scholar
Garmany, G. (1958). “Depressive states: their aetiology and treatment.” Brit. Med. J., 2, 341.Google Scholar
Hamilton, M., and White, J. M. (1959). “Clinical syndromes in depressive states.” J. Ment. Sci., 105, 985.Google Scholar
Henderson, D., and Gillespie, R. D. (1956). A Text-Book of Psychiatry. London: Oxford University Press.Google Scholar
Kallmann, F. J. (1950). “The genetics of psychoses: an analysis of 1,232 twin index families.” Congr. Internal. Psychiat., 6, 177.Google Scholar
Kiloh, L. G., and Ball, J. R. B. (1961). “Depression treated with imipramine: a follow-up study.” Brit. Med. J., 1, 168.Google Scholar
Kiloh, L. G., and Garside, R. F. (1963). “The independence of neurotic depression and endogenous depression.” Brit. J. Psychiat., 109, 451.Google Scholar
Kraepelin, E. (1913). Psychiatry. 8th edition. Leipzig.Google Scholar
Langner, T. S. (1961). “Environmental stress, degree of psychiatric impairment and type of mental disturbance.” Psychoanalysis and the Psychoanalytic Review, 47, 3.Google Scholar
Lewis, A. J. (1934). “Melancholia: a clinical survey of depressive states.” J. Ment. Sci., 80, 277.CrossRefGoogle Scholar
Lindemann, E. (1944). “Symptomatology and management of acute grief.” Atner. J. Psychiat., 101, 141.Google Scholar
Mayer-Gross, W., Slater, E., and Roth, M. (1955). Clinical Psychiatry. London: Cassell.Google Scholar
Rennie, J. A. G. (1942). “Prognosis in manic-depressive psychoses.” Amer. J. Psychiat., 98, 801.Google Scholar
Roth, M. (1960). “Phobic anxiety—depersonalisation syndrome and some general aetiological problems in psychiatry.” J. Neuropsychiat., 1, 293.Google ScholarPubMed
Sargant, W., and Dally, P. J. (1962). “Treatment of anxiety states by anti-depressant drug.” Brit. Med. J., 1, 6.Google Scholar
Slater, E. (1938). “The genetics of manic-depressive insanity. The parents and children of manic-depressives.” Z. ges. Neurol. Psychiat., 163, 1.CrossRefGoogle Scholar
Wilson, L. A., and Lawson, I. H. (1962). “Situational depression in the elderly: a study of 23 cases.” Geront. Clin. Additamentum, 59, 71.Google Scholar
Wolpe, H. (1958). Psychotherapy by Reciprocal Inhibition. California: Stanford University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.