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Positive Life Change and Recovery from Depression and Anxiety

A Three-Stage Longitudinal Study of Primary Care Attenders

Published online by Cambridge University Press:  02 January 2018

A. S. Leenstra ,
J. Ormel  and
R. Giel
A. S. Leenstra
Affiliation:
Department of Social Psychiatry
J. Ormel*
Affiliation:
Department of Social Psychiatry and Department of Health Sciences
R. Giel
Affiliation:
Department of Social Psychiatry, University of Groningen, Groningen, The Netherlands
*
Dr Ormel, Department of Psychiatry, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
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Abstract

Background

The objective was to examine the relationship between positive life change (PLC) and recovery from depression and anxiety. Following Brown et al (1988, 1992), we hypothesised: (a) that an excess of PLC would be found in the 3-month period before recovery compared with base rates (‘excess hypothesis’) and (b) that fresh-start and anchoring subtypes of PLC would trigger recovery from depression and anxiety respectively (‘specificity hypothesis’).

Method

One hundred and seventy primary care patients with a depressive and/or anxiety disorder, selected from 1994 consecutive attenders, were assessed at baseline and at 1-year and 3.5-year follow-ups on life change (LEDS) and psychopathology (PSE and Course Interview).

Results

Our results appeared to confirm the excess hypothesis regarding depression and anxiety (twofold excess was found prior to recovery), but not regarding mixed anxiety/depression. They did not support the specificity hypothesis.

Conclusions

PLC facilitates recovery but is neither a necessary nor sufficient condition for remission. Difficulty reduction is the most important recovery-enhancing factor.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 3 , March 1995 , pp. 333 - 343
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Armitage, P. & Berry, G. (1987) Statistical Methods in Medical Research. Oxford: Blackwell Scientific.Google Scholar
Bebbington, P., Der, G., MacCarthy, B., et al (1993) Stress incubation and the onset of affective disorders. British Journal of Psychiatry, 162, 358–362.Google Scholar
Brink, W. van den (1988) Course Interview for the Dating of Psychiatric Episodes. Groningen: Department of Social Psychiatry, University of Groningen.Google Scholar
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression: a Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar
Brown, G. W., Adler, Z. & Bifulco, A. (1988) Life events, difficulties and recovery from chronic depression. British Journal of Psychiatry, 152, 487–498.Google Scholar
Brown, G. W., Bifulco, A. & Andrews, B. (1990) Self-esteem and depression: IV. Effect on course and recovery. Social Psychiatry and Psychiatric Epidemiology, 25, 244–249.Google Scholar
Brown, G. W., Lemyre, L. & Bifulco, A. (1992) Social factors and recovery from anxiety and depressive disorders: a test of specificity. British Journal of Psychiatry, 161, 44–54.CrossRefGoogle ScholarPubMed
Creed, F. (1993) Life events. In Principles of Social Psychiatry (eds Brugha, D. & Leff, J.), pp. 144–161. Oxford: Blackwell Scientific.Google Scholar
Davies, M. H., Rose, S. & Cross, K. W. (1983) Life events, social interaction and psychiatric symptoms in general practice: a pilot study. Psychological Medicine, 13, 159–163.Google Scholar
Finlay-Jones, R. A., Brown, G. W., Duncan-Jones, P., et al (1980) Depression and anxiety in the community: replicating the diagnosis of a case. Psychological Medicine, 10, 445–454.CrossRefGoogle ScholarPubMed
Funch, D. P. & Marshall, J. R. (1984) Measuring life stress: factors affecting fall-off in the reporting of life events. Journal of Health and Social Behavior, 25, 453–464.Google Scholar
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnaire. Oxford: Oxford University Press.Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders: a Bio-social Model. London: Routledge.Google Scholar
Giel, R., Ten Horn, G. M. M. H., Ormel, J., et al (1978) Mental illness, neuroticism and life events in a Dutch village sample: a follow up. Psychological Medicine, 8, 235–243.Google Scholar
Holahan, C. J. & Moos, R. J. (1987) Risk, resistance and psychological distress: a longitudinal analysis with adults and children. Journal of Abnormal Psychology, 96, 3–13.CrossRefGoogle ScholarPubMed
Jablenski, A. (1987) Prediction of the course and outcome of depression. Psychological Medicine, 17, 1–9.Google Scholar
Kessler, R. C. & Wethington, E. (1991) The reliability of life event reports in a community survey. Psychological Medicine, 21, 723–738.Google Scholar
Needles, D. J. & Abramson, L. Y. (1990) Positive life events, attributional style and hopefulness. Testing a model of recovery from depression. Journal of Abnormal Psychology, 99, 156–165.Google Scholar
Oatley, K. & Perring, C. (1991) A longitudinal study of psychological and social factors affecting recovery from psychiatric breakdowns. British Journal of Psychiatry, 158, 28–32.CrossRefGoogle ScholarPubMed
Ormel, J., Stewart, R. & Sandbrman, R. (1989) Personality as modifier of the life change-distress relationship. Social Psychiatry and Psychiatric Epidemiology, 24, 187–195.Google Scholar
Ormel, J., Brink, W. van den, Koeter, M. W. J., et al (1990) Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study. Psychological Medicine, 20, 909–923.Google Scholar
Ormel, J., Oldehinkel, T., Brilman, E., et al (1993) Outcome of depression and anxiety in primary care: a three-wave 3.5 year study of psychopathology and disability. Archives of General Psychiatry, 50, 759–766.Google Scholar
Parker, G., Tennant, C. & Blignault, I. (1985) Predicting improvement in patients with non-endogenous depression. British Journal of Psychiatry, 146, 132–139.CrossRefGoogle ScholarPubMed
Reich, J. W. & Zautra, A. J. (1988) Direct and stress-moderating effects of positive life experiences. In Life Events and Psychological Functioning (ed. Cohen, L. H.), pp. 11–30. New York: Sage.Google Scholar
Surtees, P. G. (1989) Adversity and psychiatric disorder: a decay model. In Life Events and Illness (eds Brown, G. W. & Harris, T. O.), pp. 161–195. London: Guilford Press.Google Scholar
Tennant, C., Bebbington, P. & Hurry, J. (1981) The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and to neutralizing events. British Journal of Psychiatry, 139, 213–220.Google Scholar
Wilmink, F. W. (1989) Patient, Physician, Psychiatrist: Assessment of Mental Health Problems in Primary Care (Thesis, Department of Social Psychiatry, University of Groningen.Google Scholar
Wing, J. K., Cooper, J. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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