Life events and clinical subtypes of major depression: a cross-sectional study

Background

The present study aimed to investigate the relationship between stressful life events and depression.

Material and Methods

Ninety (90) patients (32 males and 58 females) aged 36.57 ± 12.02 years suffering from Major Depression according to DSM-IV criteria entered the study, and 121 controls (28 males and 93 females), aged 27.11 ± 10.59 years. Diagnosis was obtained with the SCAN v 2.0 and the IPDE. The psychometric assessment included the HDRS-17, HAS, the Newcastle Scale (version 1965 and 1971), the Diagnostic Melancholia Scale and the GAF scale. The Life Change Units (LCU) according to the method proposed by Rahe et al, were used for the quantification of life events. The Statistical Analysis included ANCOVA (with age and gender as covariates) and Pearson Correlation Coefficient.

Results

34 patients were melancholics, 17 atypicals and 39 were undifferentiated. LCU score was 126.93 ± 148.02 for controls, 151.54 ± 134.74 for depressives and 249.53 ± 152.57 for atypicals, 78.26 ± 94.46 for melancholics and 172.72 ± 124.13 for undifferentiated patients. Males reported significantly more life events than females. Atypical depressives differed both from controls and from the other depressive subtypes. Atypical males differed from all other gender-by-type groups, while no other differences were present. LCU correlated negatively with the age of onset of depression (-0.40), with indices of melancholy (-0.51), and with HDRS-17 (-0.50), but did not correlate with anxiety or functioning.

Discussion

The results of the current study suggest that subgroups of depressive patients are characterized by the presence of stressful life events. Atypical patients may report the highest load of life events. The question that arises is whether this is a true fact or these patients (which have higher personality psychopathology and interpersonal rejection sensitivity) tend to over-report life events.