Patterns in the relationship of life events and psychiatric symptoms over time

Abstract

A prospective study was conducted to investigate the relationship of life-event changes to changes in psychiatric symptoms over time. Eighty-nine male psychiatric outpatients and a comparison group of 107 hospital and university employees completed a Schedule of Recent Events (SRE) and a Symptom Checklist (SCL) every two months for 18 months. Symptoms were significantly ( p < 0.009) correlated with life events at each of the nine measurement periods ( r ranged from 0.38 to 0.58). When event and symptom scores for each subject over time were graphed, 61.7% of the cases could be classified into one of three event-symptom relationship typologies. A concordant relationship (events and symptoms covaried together) appeared in 34.7%; an unresponsive relationship (major changes in events associated with no symptom change) was seen 21.4%; and an antecedent- consequent relationship (build-up in events followed by build-up in symptoms) was identified in 5.4%; 38.3% of the cases could not be classified. Although the study supports previous findings that when large groups are studied, statistically significant events-symptoms correlations can be demonstrated, it also shows that such group data may be obscuring important individual differences. The partitioning of groups according to events-symptom typologies may help identify people whom it would be fruitful to study in greater depth from an adaptational viewpoint. In this way we may come closer to understanding why life events affect the health of some people and not others.