Life Events in Depression1

There has been a long standing interest in the possible association of stress with illness. A host of studies have suggested a positive relationship between life events and physical illness (Wolff, 1950; Schmale and Engel, 1967; Holmes and Rahe, 1967; Grant et al, 1974). A similar relationship between the onset of psycliiatric illness and life events has also been observed but with lesser consistency (Brown and Birley, 1968; Eisler and Polak, 1971; Unlenhuth and Paykel, 1972). Studies pertaining to relationship of life events and depression have been quite a few (Cohen et al., 1954; Forrest e t a l . , 1965; Paykel et al . , 1969; Patrick et al . , 1978). There is a striking dearth of reports related to life events and depression in Indian l i terature. Employing a well structured scale for life events, Venkoba Rao and Nammalvar (1976) studied a total of twenty five depressed patients in South India. The authors reported that the depressives though experiencing the same number of life events as the controls, suffered more distressing events as indicated in the mean distress scores. There was a clustering of events during the 2 year period preceding the illness. In their further work Venkoba Rao and Nammalvar (1977) matched the life events before and after the treatment in depression and observed that a high score persisted even after the t reatment . Recently, Sethi and Prakash (1979) studied a group of 40 primary depressives with PaykePs inventory and compared their life events from those of a control group consisting of an equal of schizophrenic subjects. T h e investigators reported that the depressives experienced a significantly higher number of life events than schizophrenics. I t can not be overemphasized that in such a study control is crucial but there are several problems in selecting control groups for the study of psychiatric patients. For example, a control group of hospitalized patients may be inappropria te in that the onset of some physical illness and/or the fact of being admit ted to hospital may in itself be associated with an increased frequency of life events (Hudgens, 1973) Alternatively, a healthy populat ion as compared to a hospital-patient group m a y b e ' ' too wel l" , in that pathology and care seeking are not comparable as between normal and psychiatric groups. Further, healthy subjects may repor t fewer events since they are not exposed to same kind of interviewing as psychiatr c patients. Hence ideal control would be to compare psychiatric patients with two above mentioned groups. T h e present work was undertaken with the objective of studying frequency of occurrence and the pat tern of life events prior to the inception of illness in pr imary