The course of depression

Abstract

The increasing array of available therapeutic tools for the treatment of depression has been accompanied by an increasing number of scientific articles emphasizing the recognition of depression and the classification of depressive illness and masked depressions. These articles, appearing both nationally and internationally, commonly express the need of improved classification by means of a variety of devices so that the current therapeutic potential might be realized. 1–12 Many community surveys have assessed psychopathology and psychiatric impairment in a population. Correlates of mental health measures have been examined in an attempt to discover more about the circumstances under which impairment occurs or to look for etiologic clues. What has been avoided or obscured in many discussions is the natural history of depression. This question is seemingly answered with explanations about different kinds of depression and the usage of the word depression, connoting a mood, a syndrome, or a symptom of depressive illness. The Community Mental Health Assessment project was a weekly survey that focused on depression and level of depression in the community over time. The relationship between life events and depression was also a major area of interest. In this article we will examine the scores on measures of depression and symptomatology and life events obtained in an initial interview and a 1-year follow-up interview for two community samples that provide data on the course of depression. The findings are discussed against the background of the clinical knowledge about chronic depression, situational depression, and depressive life style.