Affective disorders among women in the general population and among those referred to psychiatrists. Clinical features and demographic correlates.

In a study comparing depressive disorders detected in a field survey (n = 90) with patients referred to a specialist treatment setting (n = 63), the clinical features and demographic correlates of 'cases' of affective disorders proved to be similar. However, those in treatment settings appeared to have more people achieving definite case status. Hospital-referred cases were also more likely than community cases to be older and single, and this difference persisted even after controlling for chronicity of symptoms.

Self-esteem, life stress and psychiatric disorder.

Using a special subsample from a survey of women in Edinburgh investigations were carried out into (a) which types of life event are associated with lowered self-esteem; (b) the role of life events and self-esteem in onset of psychiatric disorder; and (c) the additional significance of prior psychiatric consultation in determining onset. Stressors involving impaired relationships with others were the only ones clearly associated with lowered self-esteem. Minor psychiatric illness was predicted by stress of uncertain outcome, and, to a lesser extent, by impaired relationship stress.

Alcoholic and non-alcoholic liver disease in relation to alcohol consumption in Scotland, 1978-84. Part I: Epidemiology of liver diseases.

A common strategy in epidemiological studies linking alcohol consumption in the general population with liver cirrhosis mortality is to use non-specific cirrhosis mortality rates in which alcoholic and non-alcoholic causes of death are not distinguished. Evidence is presented from Scottish mortality data for 1979 to 1984 that the two forms of cirrhosis have quite different epidemiological profiles. Similar findings emerge from morbidity data.

Hospital-treated and general-population morbidity from affective disorders. Comparison of prevalence and inception rates.

In this study, we compare the rates of psychiatric disorders found among women in a random sample of the general population with those of patients referred to specialist services. Both these groups were drawn from the same geographical area. The ratio of prevalence rates is less than the ratio between inception rates in the two groups.

Self-appraisal, anxiety and depression in women. A prospective enquiry.

Depressive illness is known to be associated with low self-evaluation, but it has been suggested that there may be a reciprocal connection as well, such that low self-appraisal (in the absence of illness) makes the subsequent onset of depression more likely. A prospective study, using a community sample of 376 women, provided data about clinical state over a period of 18 months, and self-appraisal questionnaire scores were determined on two occasions separated by 6 months. There was no evidence that low self-evaluation predicted future episodes of depressive illness, except in women who reported previous psychological episodes for which they had sought medical help, and, even for those with previous episodes, much of the predictive power of low self-esteem was accounted for by individuals who were subsequently recognised to have been in the early stages of illness.

Life events and other factors implicated in onset and in remission of psychiatric illness in women.

Life stressors for 574 Edinburgh women were assessed for uncertain outcome, impaired relationships and other characteristics. Thirteen weeks were covered either with no illness present or before a transient episode of Research Diagnostic Criteria (RDC)-defined anxiety/depression (duration less than 13 weeks) or before a longer episode or before illness remission or during continuing illness. Exploratory analysis suggested that stressors of uncertain outcome preceded longer illness onset.

The epidemiology of life events and long-term difficulties, with some reflections on the concept of independence.

A total of 576 women aged 18-65, drawn from an area in Edinburgh, were interviewed. Data on life events and long-term difficulties over a six-month period prior to interview were gathered and classified according to area of life, the Bedford system, the Edinburgh system, and the independence of the event or difficulty from the subject's own actions. The highest rates of Bedford system 'provoking' situations were found in the working class, among those not employed, among women with three or more children under 14, and in the separated, divorced, widowed or cohabitating group.

Self-esteem, vulnerability and psychiatric disorder in the community.

One hypothesis concerning the nature of the link between negative self-appraisal and certain psychological disorders is that low self-esteem may be a consequence of both early and current experiences, and may predispose to breakdown. An alternative view is that the negative self-concept is only to be found in the presence of illness, which is the primary cause. Results are reported from a community survey, confirming the influence of certain biographical factors on self-esteem in the absence of illness, whereas other factors appear to operate only after the onset of illness.

Life events and the onset of affective disorder. A longitudinal general population study.

This paper examines the relationship between life events (ascertained by the Bedford College method) and the onset of affective disorder (defined according to the RDC scheme) in a longitudinal general population survey of women. Fall-off in the reporting of minor events is examined and discussed. Event rates, proportions of women challenged by events, and measures of the risk of RDC disorder associated with the experience of particular events are reported.