Life Events and Depression

AN extensive literature exists regarding the relationship of life events and depression. The largest group of studies has concerned the descriptive characterization of those events occurring at the onset of depression. There has been particular emphasis on actual or symbolic losses,1-4including loss of self-esteem.5Others have been concerned with the general presence or absence of stress at onset and have attempted to define a group of endogenous depressions, occurring in the absence of stress, and showing characteristic clinical features.6-8Although it has been generally assumed that most depressions are reactions to events, some dissent has been expressed. Hudgens9and his colleagues found events uncommon in the six months prior to onset of illness in 40 patients hospitalized with affective disorders. Winokur and Pitts10reported reactive depressions to be infrequent and threw doubt on the validity of