Background. A prospective study, covering just over a
1-year period, sought to confirm an earlier
finding that around 40% of women who experience a severe life event
in the presence of two
ongoing psychosocial vulnerability factors, (negative close
relationships and low self-esteem) will
develop a major depressive episode. Distal risk factors were examined
to see if they improved prediction.Methods. A population sample of 105 mainly working-class
mothers with vulnerability and without
depression were interviewed three times over a 14-month period to
date the occurrence of severe life
events and onset of major depression. Degree of vulnerability was
assessed at first contact together
with distal risk in terms of childhood neglect/abuse
and any earlier episodes of depression.Results. Thirty-seven per cent of these vulnerable women
became depressed in the study period. The
majority experienced a severe life event, and of these, 48% had onsets.
Contrary to expectation, risk
was only a little less among those with just one of the two
vulnerability factors. Two-thirds of
women with an onset had been depressed in previous years. Although
this was associated with
increased risk, the effect was greatest for those who had experienced
an episode before age 20. A
relationship between childhood neglect/abuse and onset was
entirely accounted for by such early depression.Conclusion. An aetiological model of depression outlined
in earlier research was confined with a new
factor of teenage depression shown to increase risk of onset.
Childhood neglect: The role of the paediatrician
