Social origins of depression: a reply

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Synopsis

Many of the criticisms of our work made by Tennant & Bebbington in the current edition of this journal touch on issues which have already been discussed in our recent book Social Origins of Depression. We do not think that any of their points pose significant threats to our aetiological model of depression. We welcome this opportunity to clarify their questions about our data, and to use their re-analysis of our material as a basis for a wider discussion of certain general aspects of the statistical analysis and interpretation of data and the pitfalls which await the unwary.

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Social Class and Psychiatric Disturbance among Women in an Urban Population

George W Brown, Máire Bhrolcháin, Tirril Harris (1975)

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Contribution of life events to causation of psychiatric illness.

E Paykel (1978)

This paper discusses the magnitude of the effect of life events in the causation of psychiatric illness. It is argued that an established epidemiological concept, relative risk, provides a useful measure of association which can be approximately adapted for retrospective controlled studies. Examination of studies employing general population controls consistently indicates effects of some importance, with risks of illness increased by factors of between 2 and 7 in the 6 months after an event. Risks are greater for the more stressful types of events, greater for depression and neuroses than schizophrenia, and even greater for suicide attempts. However, similar events occur commonly and a large proportion of event occurrences are not followed by illness. Events must interact with a wide variety of background factors, and the appropriate model is one of multifactorial causation.