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Background: The aim of the study was to identify risk factors in subjects at risk for depressive disorders and controls., Methods: In a 6.5 year follow-up study we examined the effects of personality (neuroticism, frustration intolerance, rigidity, melancholic type), adverse life events and chronic difficulties on depressive symptoms in 89 high-risk subjects (HRS, siblings and children of patients suffering from an affective disorder), without any mental illness at wave 1 (T1), and 49 controls without any personal and family history of psychiatric disorder at T1. To this end, regression analysis and path analysis using a structural equation model (only for HRS) were performed., Results: Risk factors for depressive symptoms at wave 2 (T2) in HRS comprised acute adverse life events, frustration intolerance (T1) and depressive symptoms (T1). Risk factors for depressive symptoms in controls included chronic difficulties, neuroticism and rigidity. HRS had less stressful life events and the same risk for chronic difficulties, but perceived adverse events as more stressful., Limitation: The sample size of the control group is too small for identifying slight effects., Conclusion: Our results indicate that the impact on the emergence of depressive symptoms of various risk factors is different in high-risk subjects and controls. High-risk subjects are more sensitive to the depressogenic effects of acute stress and thus avoid potential stressful changes in their life to a higher extent. On the other hand, the influence of persistent factors such as personality traits (neuroticism, rigidity) and chronic difficulties on subsequent depressive symptoms was less pronounced in HRS as compared to controls.

Background: Particular patterns of personality (e.g., neuroticism, obsessionality) and difficulties in various social roles have been found to be associated with unipolar depression. Interpersonal and instrumental difficulties of depressives can be understood either as a risk factor, or as a consequence caused by the disorder itself. Concerning patients with bipolar disorder, there is some evidence that their premorbid level of occupational and educational achievement is often superior when compared to the premorbid functioning of patients with unipolar depression., Methods: Personality features and the level of social functioning of 114 high-risk subjects (healthy first-degree relatives of patients suffering from an affective disorder) have been investigated using self- and expert-ratings. Sixty-three subjects without a personal and family history of psychiatric disorder served as the reference group., Results: Relatives of melancholic depressives described themselves as more neurotic than controls but proved to be inconspicuous regarding their role functioning. Relatives of bipolar I patients were more strongly oriented toward social norms, and their instrumental role functioning was superior to that of controls. Neuroticism was strongly associated with depressive symptoms., Limitation: The statistical power of our data is sufficient to detect medium effect sizes but is insufficient for identifying small group differences., Conclusion: Whether these discriminating personality features and other variables (not characterising the high-risk group (HRG) as a whole) act as true vulnerability factor have to be clarified by a follow-up investigation.

Twenty-two inpatients with an acute major depression without an additional lifetime DSM-III axis I diagnosis were compared with 20 inpatients suffering from an acute major depression with a coexistent anxiety disorder. The comparisons focused on social dysfunction, social support, and premorbid personality features. Characteristics of provoking life events and chronic conditions of life during the year before the index admission were analyzed exploratively. Major depressives with an anxiety disorder reported a higher number of abnormal premorbid personality traits such as neuroticism and a tendency towards social isolation; they had fewer confidants and lived alone more frequently than pure major depressives. Furthermore, pure major depressives reported more non-illness-related chronic burdening conditions during the year before the onset of depression than did major depressives with an anxiety disorder. However, there were no differences between the patient groups as to social dysfunction. The results point to fewer personal and social resources of the comorbidity group.

The main aim of the present study was to examine whether the well-established association between depression and social dysfunction still remains when effects of a coexistent anxiety disorder are eliminated from the data. As these effects strongly depend on the proportion of depressed subjects suffering simultaneously from an anxiety disorder, we first examined the frequency of mixed and pure depressive disorders and that of pure anxiety disorders (control subjects) in a community sample (n = 483). Using DIS/DSM-III criteria (reference period 6 months), pure anxiety disorders were most frequent (6%), followed by pure depressive disorders (3%) and the coexistence of anxiety and depression (2%). Cases suffering from both disorders were most severely afflicted in terms of psychopathology (persistence of symptoms, comorbidity regarding other mental disorders). At the diagnostic level, the association between depression and social dysfunction was only slightly influenced by effects resulting from comorbidity; at the level of actual symptoms, however, we found that cases suffering simultaneously from severe depression and severe anxiety were significantly more handicapped in their social lives than depressive subjects with only mild anxiety symptoms.

Twenty inpatients suffering from an adjustment disorder with depressed mood according to the DSM-III criteria were compared with 22 inpatients with a (situationally provoked) major depression without an additional DSM-III/axis I diagnosis, with regard to expert- and self-rated symptomatology, social dysfunction and personality features. Furthermore, social support prior to admission was described. Subjects who had developed an adjustment disorder had less severe depressive symptomatology, associated social dysfunction and premorbid rigidity, and they remitted faster. Social support for both groups was similar to that of healthy controls.

This paper presents the findings of two independent studies which examined the test-retest reliability and the fall-off effects of the Munich Life Event List (MEL). The MEL is a three-step interview procedure for assessing life incidents which focuses on recognition processes rather than free recall. In a reliability study, test-retest coefficients of the MEL, based on a sample of 42 subjects, were quite stable over a 6-week interval. Stability for severe incidents appeared to be higher than for the less severe ones. In the fall-off study, a total rate of 30% fall-off was noted for all incidents reported retrospectively over an 8-year period. A more detailed analysis revealed average monthly fall-off effects of 0.36%. The size of fall-off effects was higher for non-severe and positive incidents than for severe incidents. This was particularly evident for the symptomatic groups. Non-symptomatic males reported a higher overall number of life incidents than females. This was partly due to more frequent reporting of severe incidents. The findings of the fall-off study do not support the common belief that the reliability of life incident report is much worse when the assessment period is extended over a period of several years as compared to the traditional 6-month period.