52:
depressed, with up to 80% of cases of major depression are preceded by some major life event, and symptoms tend to occur within one month of the event if a diagnosis of major depression is made. This high frequency of negative events is also seen relative to representative samples of the non-depressed population, with studies often showing the depressed to have experienced twice as much of these negative experiences. In addition to this, depressed individuals are more likely to have experienced negative life events preceding their symptoms compared to other mental health issues like schizophrenia and bipolar disorder.
106:. This may be due to the likelihood that these events are often caused ongoing problems or the result in them, where a quick fix is often not possible. Although it is less often mentioned in case studies, a lack of social support has also been implicated as a form of chronic stress that increases the likelihood of major depression. Like with the previously mentioned example of romantic breakups, a lack of social support may become a form of chronic stress as it is often something that cannot be fixed quickly and may be a source of conflict.
98:
hard to distinguish episodic stressors from chronic stressors as the length of many stressors is expected to vary based on individual, environmental, and cultural factors. However, the loss of a loved one can usually be considered a short-term discrete event, and such instances are estimated to result in depression 17-31% of the time. Other examples of episodic stressors include an unexpected loss of employment, robbery, and assault, all of which are known to increase the likelihood for depression.
311:
and school connectedness are heritable and unable to be fully accounted for by differences in experience alone. They are also linked to depression, which is negatively correlated with support levels in a longitudinal U.S. sample. This link between depression and a lack of social support and the heritability of aspects of social networks has led to the suggestion that part of depression's heritability likely stems from heritable differences in one's ability to form supportive social networks.
365:
bereavement clause and in the absence of dangers like suicidal behavior, a clinician can avoid the costs of a false-positive diagnosis while still monitoring their patient closely for signs of pathological depression as opposed to normal grief. To avoid the risk of false-negatives, those with a history of major depression could be diagnosed without this provisional tag due to a previous history of depression being a strong predictor for the onset of future episodes.
123:
are equally likely to become depressed in response to conflict or death within the nuclear family, while women are more likely to become depressed in response to the loss of a friend and family members outside of the nuclear family. In addition to this, women may also be more sensitive to depression when conflict exists and is physically expressed as evidenced by women being more likely to be depressed after a physical attack but not men
286:, lead to differences in how individuals respond to major life events due to mediators like rumination. In other words, certain individuals are likely to have lower thresholds for developing major depression due to how they experience different types of adversity, although even those at low risk of depression may experience depression in response to a negative event.
357:. A study by Wakefield (2007) compared depression patients whose diagnosis was triggered by death of a loved one and those whose diagnosis was triggered by a different kind of loss. The study found no major symptomatic difference between the two groups, suggesting the death of a loved one should not be treated differently than other losses.
110:
women in a
Spanish sample that compared a depressed group to controls. In addition to their direct effect on depression, both stressors have been suggested to interact, with either chronic stress making individuals more susceptible to the effects of episodic events or by negative life events adding to levels of chronic stress.
122:
In general, women are at much higher risk of developing depression after a social loss than men. One explanation for this is that women tend to have larger networks of meaningful supporters than men where an important loss can happen. Evidence for this comes primarily from the finding that both sexes
310:
Like risk factors for depression, protective factors have also been shown to be heritable. This is seen in both satisfaction with social relationships and the size of supportive networks, with heritability estimates from 17 to 31% depending on the measure and the population. For example, both family
202:
Depressed individuals tend to have lower levels of both perceived and actual support and may express this to others in ways that may exacerbate one's symptoms and put more strain on one's social relationships. Time spent in major depressive episodes is also negatively correlated with social support,
163:
levels, potentially prolonging or increasing both one's depression symptoms and the degree to which the depressed engages in feedback seeking. Therefore, although the negativity of these social impacts may be minor relative to what triggered depression, their effects may be significant once symptoms
129:
Although women are typically found to be more sensitive to social loss outside of the nuclear family as a risk factor for depression, supportive social networks have also been shown to be more protective against depression in women. For this reason, Kendler and colleagues suggest that differences in
118:
Major depression is about twice as common in women than in men. One often explored explanation for this is that women experience more negative social events than men; however, there is little evidence for this when looking at the relationship between negative events and depression as a whole. That
97:
Like other types of negative life events, the social experiences that lead to higher probabilities of developing major depression, can either be one-time events or repeated. Episodic events are those with clear beginnings and endings, which usually involve a specific time frame. However, it is often
344:
Those in favor of this change argue that while grief related to the loss of a loved one and major depression share many overlapping symptoms, they are not the same thing and that, therefore, bereavement should not prevent a depression diagnosis. Although depression could still be diagnosed with the
260:
Although conflict and social support are often viewed as opposites, it is likely that both are the result of different mechanisms so that high levels of conflict do not necessarily have the same impact as low levels of social support. This is seen in that although low parental support is predictive
151:
Of the ways depression might lead to increased social stressors, negative feedback seeking and reassurance seeking are two of the most explored. Both behaviors involve questioning social partners about oneself in ways that are aversive to others, differing in whether the feedback sought is positive
88:
Although independent events are less associated with depression and social content, they are still positively associated with depression. In addition to this, they have helped contribute evidence for the causal relationship between negative life events and depression, as with dependent events there
76:
that result from interactions with people in addition to variables like performance-based job security and avoidable financial problems. They are more strongly associated with depression than independent events when controlling for severity and may be the result of traits that lead individuals into
51:
Evidence for the association between negative life events and depression comes largely from case studies and studies that compare the frequency of these events in depressed individuals to rates in people who are representative of the larger population. Negative life events are often reported by the
360:
Critics of the change emphasize that the depressive symptoms seen during bereavement are often normal and that the inclusion of the bereavement exclusion was important to prevent overdiagnosis. Like the proponents of removing the exclusion, they emphasize that grieving individuals often experience
328:
Social factors are also relevant when it comes to diagnosing depression. An exclusion for the diagnosis of depression due to bereavement was originally observed at the back of the DSM-III, noting that because "a full depressive syndrome frequently is a normal reaction to the death of a loved one",
293:
Many examples for of the negative life events often associated with depression being heritable come from within the family and romantic relationships. Within the family, cohesion, organization, expressiveness, activity, control, and conflict are all heritable, with estimates ranging from 18 to 30%
175:
In addition to the loss of a relationship with a loved one, conflict has also been suggested as another way social factors can bring about depression. Divorce, separation, and the threat of either often result in both conflict and depression, and serious marital problems and divorce are two of the
109:
Both negative life events and chronic stress have each been shown to contribute to the onset of depression, and the two may combine to increase one's risk of depression. For example, acute and chronic stressors were found to increase the likelihood of depression to similar degrees in both men and
319:
are often highlighted as one potential mediator, as extraverts are likely to have larger social networks. In line with this reasoning, extraverts are more likely to experience positive life events, especially those that are dependent on one's behavior. However, it is unclear whether positive life
289:
Another source for the heritability of depression likely comes through the heritability of the social stressors commonly associated with depression. This is true of both independent events and dependent events, with a review by
Kendler and Baker (2007) showing heritabilites ranging from 7-39% for
42:
Negative social life events have been found to greatly increase one's risk of depression and clinicians are often quick to check if any major life events have preceded their patient's symptoms. This relationship is largely thought to be causal, with the strongest evidence of causation coming from
155:
Evidence compatible with reassurance seeking and negative feedback seeking increasing social stress and depression symptoms comes from the frequency of these behaviors among the depressed and the responses of others that often accompany these actions. For example, depressed individuals have been
138:
In addition to negative life events leading to depression, researchers have suggested that depression may also worsen one's social environment, which can further elevate the symptoms of major depression and one's risk of experiencing negative events. This connection between depression and social
269:
As with the depressed in general, responses to depressed family members are often aversive. This is seen in that parents of the depressed tend to provide less support and neglect their children more than parents of non-depressed individuals. However, depression has also been found to reduce the
186:
The relationship between conflict and depression is also seen through assault. This is seen primarily in the short-term, with assault often being the event with the highest likelihood of being correlated with depression after the fact. However, long-term affects are also seen, in that childhood
364:
Instead of removing the bereavement exclusion, Wakefield and First (2012) favor the use of provisional qualifiers and the use of patient history to balance the risks of over- and under-diagnosis. They argue that by classifying someone as provisionally normal before the two-month cut-off of the
101:
In addition to differences in the length of stressful events, researchers have also emphasized that different types of events may relate to differences in how stress is experienced. For example, episodic events like romantic breakups, economic hardship, or assault can result in long periods of
59:
behavior is often seen as normal and healthy and not worthy of a diagnosis indicating pathology. However, one's history with major depression, levels of social support, gender, sex, and personality differences have all been suggested to play roles in mediating one's sensitivity to pathological
198:
levels have a strong inverse relationship with one's risk of becoming depressed despite the challenges that come with measuring them. This effect is most strongly felt in women, who tend to have larger support networks and are more likely to become depressed in response to conflict or loss in
352:
The major risk of underdiagnosis due to the bereavement clause is that it would prevent individuals from getting the treatment they could receive with a diagnosis. This is exacerbated by the fact that depression is a risk factor for suicide, thereby creating situations where treatment may be
301:
This connection between depression and heritable negative life events has led to the suggestion that part of the heritability of depression stems from greater risk of experiencing environments more likely to lead to its occurrence. However, it is unlikely to be a complete explanation for the
206:
However, the degree to which the relationship between social support and depression is casual is still uncertain. Questions about causality often come from the possibility that social support levels may be tied to other traits that also play a role in depression. For example, in addition to
699:
Spinhoven P, Elzinga B, Roelofs K, Hovens JG, van Oppen P, Zitman FG, Penninx BW (September 2011). "The effects of neuroticism, extraversion, and positive and negative life events on a one-year course of depressive symptoms in euthymic previously depressed patients versus healthy controls".
256:
Multiple risk factors for adolescent depression have been identified within the family. Among the strongest is the degree to which conflict is present within a family, with more conflict being associated with greater risk of depression. In addition to this, parental responses to sadness or
219:
In today's culture of social networks being tied to social media and with the high numbers of social media users, studies have been conducted recently to determine if there is a relationship between social media use and depression. This topic of research in regard to college students is of
47:
factors that may be related to its onset. However, noncausal associations are also likely as individuals who are more likely to be depressed may increase their chance of experiencing a negative social event due to placing themselves into relationships where these events may be more common.
302:
heritability of depression, with one estimate being that the heritability of negative life events account 10-15% of the total heritability of depression. Likewise, the effect of genetic polymoprhisms on negative life effents alone is relatively small compared to environmental differences.
43:
findings that negative events outside of one's control are strongly associated with depression, making it unlikely that depression symptoms had anything to do with the negative event. Additional support comes from twin studies, which allow for researchers to control for
139:
stressors is best seen through depressed individuals being more likely to experience more negative social events during their depression than non-depressed individuals or those with other conditions. In particular, depressed individuals are more likely to experience
80:
Dependent events are also thought to be more strongly associated with major depression symptoms in people who have a history of it than those experiencing it for the first time. However, the validity of this statement may be dependent on whether one is focusing on
2510:
Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, Tabor J, Beuhring T, Sieving RE, Shew M, Ireland M, Bearinger LH, Udry JR (September 1997). "Protecting adolescents from harm. Findings from the
National Longitudinal Study on Adolescent Health".
345:
bereavement clause in place if the individual was suicidal, psychotic, or had trouble with day to day tasks, proponents of its removal argue that underdiagnosis of depression was still a risk due to certain severe symptoms not meeting the criteria (e.g.,
215:
In addition to low levels of support being a risk factor for depression, high levels are also widely considered to have protective effects. However, these results are not universal and often come from studies limited to self-reports from the depressed.
68:
The negative life events that lead to depression are often classified as dependent or independent, with dependent events being those an individual has some control over and independent events being those which are mostly due to unavoidable chance.
224:'s National College Health Assessment for Spring 2019, 46.2% of American undergraduate college students reported feeling "so depressed that it was difficult to function" at any time in the past 12 months. Studies published in the journals
353:
lifesaving. For this reason, proponents of the exclusion's removal argue that the judgement of clinicians needs to be unconstrained by whether or not an individual has lost a loved one and that this would be sufficient in preventing its
211:
which may help buffer against negative life events. Therefore, a trait that lessons the extent of one's social network may also result in more social adversity or negatively impact one's risk of depression in other, indirect ways.
337:, where individuals experiencing depression symptoms were not considered depressed if the symptoms were in response to the death of a loved one and ended within two months. However, this bereavement exclusion was removed under
954:
Rojo-Moreno L, Livianos-Aldana L, Cervera-Martínez G, Dominguez-Carabantes JA, Reig-Cebrian MJ (December 2002). "The role of stress in the onset of depressive disorders. A controlled study in a
Spanish clinical sample".
361:
symptoms used to diagnose major depression; however, they argue that these symptoms can often be resolved without treatment and often fail to become the chronic or recurrent symptoms that should define major depression.
294:
depending on the variable. Divorce, which may be particularly likely to result in depression, is moderately heritable with about 35% of differences in one's susceptibility to divorce stemming from genetic differences.
257:
discontent are also tied to the likelihood of major depression, with both increased aggression and suppressed aggression towards dysphoric children being associated with greater likelihoods of adolescent depression.
314:
As with predictors of depression, differences in the protective factors associated with social network size and satisfaction may be tied to differences in personality. In particular, differences in one's degree of
297:
Negative social life events outside of the family are also heritable. This is seen in assault (including rape and mugging), troubles getting along with others in social networks, and job loss all being heritable.
270:
chance that a parent will act aggressively towards their child, an outcome that is compatible with evolutionary approaches emphasizing depression's role as a potential signal of need or a bargaining strategy.
77:
situations that are more likely to result in depression. In addition to this, they are likely to be more directly related to interpersonal content, at least immediately following when the stressor is felt.
1707:
Leskelä U, Melartin T, Rytsälä H, Sokero P, Lestelä-Mielonen P, Isometsä E (December 2008). "The influence of major depressive disorder on objective and subjective social support: a prospective study".
126:
Another potential explanation is that women experience greater strain than men and have fewer ways to manage or lessen their difficulties. However, there is currently little direct evidence for this.
1965:
Shensa A, Sidani JE, Escobar-Viera CG, Chu KH, Bowman ND, Knight JM, Primack BA (November 17, 2018). "Real-life closeness of social media contacts and depressive symptoms among university students".
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Jacobson KC, Rowe DC (July 1999). "Genetic and environmental influences on the relationships between family connectedness, school connectedness, and adolescent depressed mood: sex differences".
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Jasso-Medrano JL, López-Rosales F (October 1, 2018). "Measuring the relationship between social media use and addictive behavior and depression and suicide ideation among university students".
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Kandler C, Bleidorn W, Riemann R, Angleitner A, Spinath FM (January 2012). "Life events as environmental States and genetic traits and the role of personality: a longitudinal twin study".
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Although negative social experiences are often reported as preceding depression, most people do not get diagnosed with major depression. Part of this stems from the fact that grieving or
290:
many social causes of the adversity associated with depression. When looking at major life events in general, this grows to 20-50% depending on the study and the outcome being examined.
282:
of 31-42%, with women having higher estimates than men. One common explanation for why depression risk varies in response to genetic differences is that personality traits, especially
130:
sensitivity to social stressors alone cannot explain the sex difference in depression on its own since the larger social networks of women likely reduce their risk of depression.
167:
In terms of directly connection these behaviors to depression, reassurance seeking style has been reported to be associated with depression symptoms among those experiencing it.
236:
found that university students who limited time spent on social media for an extended period of time had decreased levels of depression. Another study published in 2018 in the
2063:
Schwartz OS, Dudgeon P, Sheeber LB, Yap MB, Simmons JG, Allen NB (May 2011). "Observed maternal responses to adolescent behaviour predict the onset of major depression".
207:
depression tending to produce negative reactions from others after the fact people with low social support may simply be less interested or less skilled in developing
2315:
1648:
232:
in 2018 have found that problematic or addictive social media use is strongly associated with depression or depressive symptoms. Meanwhile, a study from 2018 in the
497:
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248:
The family is a potential source of both important social support and conflict, both of which are associated with differences in the likelihood of depression.
2331:"Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals"
34:, all of which have been found affect the likelihood of someone experiencing major depression, the length of the depression, or the severity of the symptoms.
1398:
Joiner TE, Metalsky GI (October 1995). "A prospective test of an integrative interpersonal theory of depression: a naturalistic study of college roommates".
261:
of depression within the family, high social support from one parent may not be enough to provide protective effects in response to conflict with the other.
203:
but it is unclear whether longer bouts of depression lessen perceived or actual support or if social support helped the depressed return to normal faster.
176:
strongest predictors of depression. Conflict with other family members is also predictive of depression, although not to the extent of marital problems.
240:
found that having close, real-life relationships with social media contacts "was significantly associated with decreased odds of depressive symptoms".
2150:
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349:, rapid weight loss, or trouble concentrating) and the concern that individuals may hide certain symptoms due to fears of being institutionalized.
2661:"Validity of the bereavement exclusion to major depression: does the empirical evidence support the proposal to eliminate the exclusion in DSM-5?"
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2330:
1476:
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119:
being said, much variability exists when looking negative event type and risk of depression, particularly if they involve a social component.
374:
156:
found to engage more in both behaviors than non-depressed individuals and may fail to benefit from positive feedback when it is available.
2728:
183:, who are more likely to be depressed if they are currently in conflict with anyone, especially if that person is outside of their family.
1436:
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the patient's condition was better understood as
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Reactions to negative feedback and reassurance seeking often include increased likelihood of rejection and contribute to low
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significant interest due to the high rates of depression reported in this group. For example, in the
143:. However, it is unclear what effect increased rejection has on one's experience with depression.
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2187:"Evolutionary theories of depression: a critical review"
114:
Sex and gender differences in sensitivity to social loss
1924:
Hunt MG, Marx R, Lipson C, Young J (November 8, 2018).
876:"Stress and depression: old questions, new approaches"
324:DSM-5 and the removal of the bereavement exclusion
306:Heritability of protective factors for depression
278:Major depression is estimated to have a moderate
613:Hammen C (April 2005). "Stress and depression".
274:Heritability of social predictors of depression
957:Social Psychiatry and Psychiatric Epidemiology
8:
2314:: CS1 maint: DOI inactive as of July 2024 (
2152:Journal of Personality and Social Psychology
1438:Journal of Personality and Social Psychology
1400:Journal of Personality and Social Psychology
553:Acta Psychiatrica Scandinavica. Supplementum
133:
1758:Clinical Child and Family Psychology Review
998:Hagen EH, Rosenström T (January 1, 2016).
320:events are protective against depression.
199:relationships outside the nuclear family.
2684:
2632:
2591:
2392:
2202:
2126:
1941:
1930:Journal of Social and Clinical Psychology
1857:
1710:The Journal of Nervous and Mental Disease
1672:
1588:
1315:Journal of Social and Clinical Psychology
1163:
1023:
929:. New York: The Guilford Press. pp.
702:The Journal of Nervous and Mental Disease
407:Clinical Psychology: Science and Practice
234:Journal of Social and Clinical Psychology
147:Negative feedback and reassurance seeking
134:Depression's role in negative life events
2659:Wakefield JC, First MB (February 2012).
265:Familial reactions towards the depressed
72:Dependent events typically involve most
1614:The American Journal of Orthopsychiatry
627:10.1146/annurev.clinpsy.1.102803.143938
390:
2654:
2652:
2569:
2567:
2307:
2096:
2094:
2058:
2056:
2054:
1751:
1749:
1747:
1702:
1700:
1523:
1521:
1519:
1517:
1515:
1471:
1469:
1467:
1431:
1429:
1393:
1391:
1389:
1387:
1230:
1228:
1226:
1133:
1131:
1129:
1127:
1091:
1089:
1045:
1043:
1004:Evolution, Medicine, and Public Health
2267:
2265:
2263:
2261:
2259:
2257:
2018:
2016:
2014:
2012:
1138:Kendler KS, Gardner CO (April 2014).
869:
867:
492:
490:
488:
486:
450:
448:
375:Evolutionary approaches to depression
16:Risk factors in developing an illness
7:
2580:Innovations in Clinical Neuroscience
1478:Journal of Abnormal Child Psychology
747:
745:
743:
741:
739:
615:Annual Review of Clinical Psychology
608:
606:
604:
602:
600:
598:
596:
594:
592:
590:
546:
544:
542:
540:
538:
536:
446:
444:
442:
440:
438:
436:
434:
432:
430:
428:
400:
398:
396:
394:
222:American College Health Association
64:Dependent versus independent events
2228:The American Journal of Psychiatry
1967:Journal of American College Health
1530:The American Journal of Psychiatry
1144:The American Journal of Psychiatry
1098:The American Journal of Psychiatry
842:. London: Tavistock Publications.
565:10.1111/j.1600-0447.1994.tb05803.x
457:The American Journal of Psychiatry
419:10.1111/j.1468-2850.1998.tb00151.x
238:Journal of American College Health
93:Episodic events and chronic stress
14:
2426:The British Journal of Psychiatry
2525:10.1001/jama.1997.03550100049038
670:10.1111/j.1600-0447.2011.01768.x
1842:10.1016/j.socscimed.2017.03.061
927:Handbook of Affective Disorders
923:"Life Events and Social Stress"
20:Social predictors of depression
2338:Behaviour Research and Therapy
2191:Canadian Journal of Psychiatry
2107:Journal of Abnormal Psychology
2065:Behaviour Research and Therapy
1653:Journal of Affective Disorders
1350:Journal of Abnormal Psychology
1280:Journal of Abnormal Psychology
1237:Journal of Abnormal Psychology
1189:Journal of Abnormal Psychology
1156:10.1176/appi.ajp.2013.13101375
658:Acta Psychiatrica Scandinavica
252:Risk factors within the family
1:
1979:10.1080/07448481.2018.1440575
1830:Social Science & Medicine
880:Current Opinion in Psychology
226:Social Science & Medicine
2240:10.1176/appi.ajp.157.10.1552
1722:10.1097/nmd.0b013e31818ec6cf
892:10.1016/j.copsyc.2014.12.024
838:Brown GW, Harris TO (1978).
714:10.1097/nmd.0b013e318229d21f
2729:Social problems in medicine
2677:10.1016/j.wpsyc.2012.01.002
2119:10.1037/0021-843x.116.1.144
1943:10.1521/jscp.2018.37.10.751
1883:Computers in Human Behavior
1292:10.1037/0021-843x.100.4.555
1249:10.1037/0021-843x.105.3.358
921:Paykel E, Cooper Z (1992).
230:Computers in Human Behavior
38:Negative social life events
2745:
2350:10.1016/j.brat.2008.10.002
2288:(inactive July 10, 2024).
2204:10.1177/070674371105601203
2185:Hagen EH (December 2011).
2164:10.1037/0022-3514.64.4.602
2077:10.1016/j.brat.2011.02.008
2037:10.1037/0012-1649.35.4.926
1450:10.1037/0022-3514.68.4.664
1412:10.1037/0022-3514.69.4.778
1201:10.1037/0021-843x.85.2.186
1110:10.1176/appi.ajp.162.2.250
2714:Major depressive disorder
2634:10.1001/archpsyc.64.4.433
2481:10.1007/s10519-011-9491-0
2385:10.1017/S0033291712002589
2286:10.1017/S0033291706009524
1895:10.1016/j.chb.2018.05.003
1665:10.1016/j.jad.2016.01.048
1327:10.1521/jscp.1992.11.1.43
1064:10.1017/s0033291796004187
969:10.1007/s00127-002-0595-y
874:Hammen CL (August 2015).
809:10.1017/s0033291798007752
766:10.1017/s0033291701003877
511:10.1017/s0033291797004716
380:Major depressive disorder
244:Depression and the family
2025:Developmental Psychology
1770:10.1023/a:1009524626436
1490:10.1023/a:1025768504415
2724:Determinants of health
2373:Psychological Medicine
2274:Psychological Medicine
1052:Psychological Medicine
797:Psychological Medicine
754:Psychological Medicine
499:Psychological Medicine
2574:Pies RW (July 2014).
2438:10.1192/bjp.152.6.766
1581:10.1093/geronb/gbu080
1542:10.1176/ajp.152.6.833
925:. In Paykel E (ed.).
469:10.1176/ajp.156.6.837
191:Social support levels
2615:Wakefield J (2007).
2621:Arch Gen Psychiatry
1016:10.1093/emph/eow006
2469:Behavior Genetics
2736:
2699:
2698:
2688:
2665:World Psychiatry
2656:
2647:
2646:
2636:
2612:
2606:
2605:
2595:
2571:
2562:
2561:
2559:
2557:
2543:
2537:
2536:
2507:
2501:
2500:
2464:
2458:
2457:
2421:
2415:
2414:
2396:
2368:
2362:
2361:
2335:
2326:
2320:
2319:
2313:
2305:
2269:
2252:
2251:
2223:
2217:
2216:
2206:
2182:
2176:
2175:
2147:
2141:
2140:
2130:
2098:
2089:
2088:
2060:
2049:
2048:
2020:
2007:
2006:
1962:
1956:
1955:
1945:
1921:
1915:
1914:
1878:
1872:
1871:
1861:
1821:
1815:
1814:
1812:
1810:
1796:
1790:
1789:
1753:
1742:
1741:
1704:
1695:
1694:
1676:
1644:
1638:
1637:
1626:10.1037/h0080194
1609:
1603:
1602:
1592:
1560:
1554:
1553:
1525:
1510:
1509:
1473:
1462:
1461:
1433:
1424:
1423:
1395:
1382:
1381:
1362:10.1037/a0013866
1345:
1339:
1338:
1310:
1304:
1303:
1275:
1269:
1268:
1232:
1221:
1220:
1184:
1178:
1177:
1167:
1135:
1122:
1121:
1093:
1084:
1083:
1047:
1038:
1037:
1027:
995:
989:
988:
951:
945:
944:
918:
912:
911:
871:
862:
861:
835:
829:
828:
792:
786:
785:
749:
734:
733:
696:
690:
689:
653:
647:
646:
610:
585:
584:
548:
531:
530:
494:
481:
480:
452:
423:
422:
402:
141:social rejection
24:major depression
2744:
2743:
2739:
2738:
2737:
2735:
2734:
2733:
2704:
2703:
2702:
2658:
2657:
2650:
2614:
2613:
2609:
2573:
2572:
2565:
2555:
2553:
2545:
2544:
2540:
2509:
2508:
2504:
2466:
2465:
2461:
2423:
2422:
2418:
2370:
2369:
2365:
2333:
2328:
2327:
2323:
2306:
2271:
2270:
2255:
2234:(10): 1552–62.
2225:
2224:
2220:
2184:
2183:
2179:
2149:
2148:
2144:
2100:
2099:
2092:
2062:
2061:
2052:
2022:
2021:
2010:
1964:
1963:
1959:
1936:(10): 751–768.
1923:
1922:
1918:
1880:
1879:
1875:
1823:
1822:
1818:
1808:
1806:
1798:
1797:
1793:
1755:
1754:
1745:
1706:
1705:
1698:
1646:
1645:
1641:
1611:
1610:
1606:
1562:
1561:
1557:
1527:
1526:
1513:
1475:
1474:
1465:
1435:
1434:
1427:
1397:
1396:
1385:
1347:
1346:
1342:
1312:
1311:
1307:
1277:
1276:
1272:
1234:
1233:
1224:
1186:
1185:
1181:
1137:
1136:
1125:
1095:
1094:
1087:
1049:
1048:
1041:
997:
996:
992:
953:
952:
948:
941:
920:
919:
915:
873:
872:
865:
850:
837:
836:
832:
794:
793:
789:
751:
750:
737:
698:
697:
693:
655:
654:
650:
612:
611:
588:
550:
549:
534:
496:
495:
484:
454:
453:
426:
404:
403:
392:
388:
371:
326:
308:
276:
267:
254:
246:
209:social networks
193:
173:
149:
136:
116:
95:
66:
40:
17:
12:
11:
5:
2742:
2740:
2732:
2731:
2726:
2721:
2716:
2706:
2705:
2701:
2700:
2648:
2607:
2586:(7–8): 19–22.
2563:
2538:
2519:(10): 823–32.
2502:
2459:
2416:
2379:(9): 1965–71.
2363:
2344:(12): 1283–9.
2321:
2253:
2218:
2197:(12): 716–26.
2177:
2142:
2090:
2050:
2008:
1973:(8): 747–753.
1957:
1916:
1873:
1816:
1791:
1743:
1716:(12): 876–83.
1696:
1674:2027.42/136039
1639:
1604:
1555:
1511:
1463:
1425:
1383:
1340:
1305:
1270:
1222:
1195:(2): 186–193.
1179:
1123:
1085:
1039:
990:
946:
939:
913:
863:
849:978-0422763103
848:
830:
787:
760:(4): 593–604.
735:
691:
648:
621:(1): 293–319.
586:
532:
482:
424:
413:(3): 291–313.
389:
387:
384:
383:
382:
377:
370:
367:
325:
322:
307:
304:
275:
272:
266:
263:
253:
250:
245:
242:
196:Social support
192:
189:
172:
169:
148:
145:
135:
132:
115:
112:
104:chronic stress
94:
91:
65:
62:
39:
36:
32:social support
15:
13:
10:
9:
6:
4:
3:
2:
2741:
2730:
2727:
2725:
2722:
2720:
2717:
2715:
2712:
2711:
2709:
2696:
2692:
2687:
2682:
2678:
2674:
2670:
2666:
2662:
2655:
2653:
2649:
2644:
2640:
2635:
2630:
2627:(4): 433–40.
2626:
2622:
2618:
2611:
2608:
2603:
2599:
2594:
2589:
2585:
2581:
2577:
2570:
2568:
2564:
2552:
2548:
2542:
2539:
2534:
2530:
2526:
2522:
2518:
2514:
2506:
2503:
2498:
2494:
2490:
2486:
2482:
2478:
2474:
2470:
2463:
2460:
2455:
2451:
2447:
2443:
2439:
2435:
2431:
2427:
2420:
2417:
2412:
2408:
2404:
2400:
2395:
2390:
2386:
2382:
2378:
2374:
2367:
2364:
2359:
2355:
2351:
2347:
2343:
2339:
2332:
2325:
2322:
2317:
2311:
2303:
2299:
2295:
2291:
2287:
2283:
2280:(5): 615–26.
2279:
2275:
2268:
2266:
2264:
2262:
2260:
2258:
2254:
2249:
2245:
2241:
2237:
2233:
2229:
2222:
2219:
2214:
2210:
2205:
2200:
2196:
2192:
2188:
2181:
2178:
2173:
2169:
2165:
2161:
2158:(4): 602–12.
2157:
2153:
2146:
2143:
2138:
2134:
2129:
2124:
2120:
2116:
2113:(1): 144–54.
2112:
2108:
2104:
2097:
2095:
2091:
2086:
2082:
2078:
2074:
2070:
2066:
2059:
2057:
2055:
2051:
2046:
2042:
2038:
2034:
2031:(4): 926–39.
2030:
2026:
2019:
2017:
2015:
2013:
2009:
2004:
2000:
1996:
1992:
1988:
1984:
1980:
1976:
1972:
1968:
1961:
1958:
1953:
1949:
1944:
1939:
1935:
1931:
1927:
1920:
1917:
1912:
1908:
1904:
1900:
1896:
1892:
1888:
1884:
1877:
1874:
1869:
1865:
1860:
1855:
1851:
1847:
1843:
1839:
1835:
1831:
1827:
1820:
1817:
1805:
1801:
1795:
1792:
1787:
1783:
1779:
1775:
1771:
1767:
1763:
1759:
1752:
1750:
1748:
1744:
1739:
1735:
1731:
1727:
1723:
1719:
1715:
1711:
1703:
1701:
1697:
1692:
1688:
1684:
1680:
1675:
1670:
1666:
1662:
1658:
1654:
1650:
1643:
1640:
1635:
1631:
1627:
1623:
1620:(3): 437–48.
1619:
1615:
1608:
1605:
1600:
1596:
1591:
1586:
1582:
1578:
1575:(6): 948–56.
1574:
1570:
1566:
1559:
1556:
1551:
1547:
1543:
1539:
1536:(6): 833–42.
1535:
1531:
1524:
1522:
1520:
1518:
1516:
1512:
1507:
1503:
1499:
1495:
1491:
1487:
1484:(4): 333–44.
1483:
1479:
1472:
1470:
1468:
1464:
1459:
1455:
1451:
1447:
1444:(4): 664–70.
1443:
1439:
1432:
1430:
1426:
1421:
1417:
1413:
1409:
1406:(4): 778–88.
1405:
1401:
1394:
1392:
1390:
1388:
1384:
1379:
1375:
1371:
1367:
1363:
1359:
1356:(4): 762–75.
1355:
1351:
1344:
1341:
1336:
1332:
1328:
1324:
1320:
1316:
1309:
1306:
1301:
1297:
1293:
1289:
1286:(4): 555–61.
1285:
1281:
1274:
1271:
1266:
1262:
1258:
1254:
1250:
1246:
1243:(3): 358–68.
1242:
1238:
1231:
1229:
1227:
1223:
1218:
1214:
1210:
1206:
1202:
1198:
1194:
1190:
1183:
1180:
1175:
1171:
1166:
1161:
1157:
1153:
1150:(4): 426–35.
1149:
1145:
1141:
1134:
1132:
1130:
1128:
1124:
1119:
1115:
1111:
1107:
1103:
1099:
1092:
1090:
1086:
1081:
1077:
1073:
1069:
1065:
1061:
1057:
1053:
1046:
1044:
1040:
1035:
1031:
1026:
1021:
1017:
1013:
1010:(1): 117–32.
1009:
1005:
1001:
994:
991:
986:
982:
978:
974:
970:
966:
963:(12): 592–8.
962:
958:
950:
947:
942:
940:9780898626742
936:
932:
928:
924:
917:
914:
909:
905:
901:
897:
893:
889:
885:
881:
877:
870:
868:
864:
859:
855:
851:
845:
841:
834:
831:
826:
822:
818:
814:
810:
806:
803:(1): 135–44.
802:
798:
791:
788:
783:
779:
775:
771:
767:
763:
759:
755:
748:
746:
744:
742:
740:
736:
731:
727:
723:
719:
715:
711:
707:
703:
695:
692:
687:
683:
679:
675:
671:
667:
664:(6): 487–94.
663:
659:
652:
649:
644:
640:
636:
632:
628:
624:
620:
616:
609:
607:
605:
603:
601:
599:
597:
595:
593:
591:
587:
582:
578:
574:
570:
566:
562:
558:
554:
547:
545:
543:
541:
539:
537:
533:
528:
524:
520:
516:
512:
508:
505:(3): 539–47.
504:
500:
493:
491:
489:
487:
483:
478:
474:
470:
466:
463:(6): 837–41.
462:
458:
451:
449:
447:
445:
443:
441:
439:
437:
435:
433:
431:
429:
425:
420:
416:
412:
408:
401:
399:
397:
395:
391:
385:
381:
378:
376:
373:
372:
368:
366:
362:
358:
356:
355:overdiagnosis
350:
348:
342:
340:
336:
332:
323:
321:
318:
312:
305:
303:
299:
295:
291:
287:
285:
281:
273:
271:
264:
262:
258:
251:
249:
243:
241:
239:
235:
231:
227:
223:
217:
213:
210:
204:
200:
197:
190:
188:
184:
182:
177:
170:
168:
165:
164:are present.
162:
157:
153:
152:or negative
146:
144:
142:
131:
127:
124:
120:
113:
111:
107:
105:
99:
92:
90:
86:
84:
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