title: Positive life change and recovery from depression and anxiety. A three-stage longitudinal study of primary care attenders.
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').
  
  
  METHODS
  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.
authors.affiliation: Department of Social Psychiatry, University of Groningen, The Netherlands.
authors.forename: A S
authors.initials: AS
authors.lastname: Leenstra
authors.forename: J
authors.initials: J
authors.lastname: Ormel
authors.forename: R
authors.initials: R
authors.lastname: Giel
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010348:Patient Care Team; D010555:Personality Inventory; D011320:Primary Health Care