The many faces of depression following spousal bereavement.
While it is becoming increasingly clear that mood disorders tend to be chronic, intermittent and/or recurrent conditions with different manifestations over time, little is known of the variability or course of mood disorders that are associated with severe psychosocial stress. This paper reports on the prevalence and course of major, minor, and subsyndromal depressions in 328 widows and widowers followed prospectively from 2 to 25 months following one of the most disruptive of all naturally occurring stressors, spousal bereavement. The results are consistent with the following conclusions: (1) past major depression (prior to the death) predicts an increased risk for major depression following bereavement; (2) membership in any of the unipolar subgroups, in turn, predicts future depression throughout the unipolar depressive spectrum; (3) subsyndromal and minor depression stand between major depression, on the one hand, and no depression, on the other, in terms of their effects on overall adjustment to widowhood. Thus, the results support the validity of subsyndromal depression, and that the three subgroups (major, minor and subsyndromal depression) are pleiomorphic manifestations of the same unipolar depression disorder.
Zisook
S
S
University of California, San Diego, Department of Psychiatry, La Jolla 92093, USA.
Paulus
M
M
Shuchter
S R
SR
Judd
L L
LL
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001601:Bereavement; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000145:classification* / Q000175:diagnosis / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D017805:Widowhood / Q000523:psychology*