Brown G W, Harris T O, Eales M J
Department of Social Policy and Social Science, Royal Holloway and Bedford New College, London.
Psychol Med. 1993 Feb;23(1):155-65. doi: 10.1017/s0033291700038940.
An earlier paper documented that adverse experiences in childhood and adolescence considerably raise risk of both depressive and anxiety conditions (with the exception of mild agoraphobia and simple phobia) in adult life. This paper deals with the same inner-city women with children at home. Consideration of adverse experiences throughout adulthood as a whole (excluding the period just before onset) particularly involving major prior losses suggests that rather different aetiological processes may be involved. Depression appears to be often linked to experiences of major loss in adulthood as a whole and to be particularly susceptible to shortcomings in the quality of ongoing social support. For anxiety only early adverse experiences appeared to be critical. (However, the onset of both conditions is often provoked by a severely threatening event in the most recent period--particularly 'loss' in depression, and 'danger' in anxiety.) Finally the critical role of early experience for both anxiety and depression explains to a considerable extent why they so often occur together; and social factors not studied in the present enquiry may account for some of the remaining unexplained comorbidity.
一篇早期论文记载，童年和青少年时期的不良经历会显著增加成年后出现抑郁和焦虑状况（轻度广场恐惧症和单纯恐惧症除外）的风险。本文研究对象为同样那些家中有孩子的市中心区女性。将整个成年期的不良经历（不包括发病前那段时间），尤其是先前的重大损失考虑在内，表明可能涉及截然不同的病因过程。抑郁症似乎常常与成年期整体的重大损失经历相关，并且特别容易受到持续社会支持质量缺陷的影响。对于焦虑症而言，似乎只有早期的不良经历才至关重要。（然而，这两种状况的发病往往是由最近一段时间内的严重威胁性事件引发的——在抑郁症中尤其是“损失”，在焦虑症中是“危险”。）最后，早期经历对焦虑症和抑郁症的关键作用在很大程度上解释了它们为何经常同时出现；而本研究未涉及的社会因素可能是剩余部分无法解释的共病现象的部分原因。
