Psychosocial aspects of depressive disorders
Abstract: The objective of this study was to elucidate the possible importance of factors from the social environment for the development of depression. As a theoretical framework, Engel's biopsychosocial model (Engel, 1980), based on systems theory, has been applied. Proceeding from the single individual (characterized by experience, personality, behaviour) as the highest level of the organismic hierarchy the following system levels have been taken into account: dyads, family, community, culture-subculture.The depressive patients (n=lll) showed to be living in a narrowed social network and to lack confiding relationships compared with a non-psychiatric control sample (n=98). The personality characteristics (e.g. anxiety, detachment, suspicion) of the patients were related to experienced loneliness, contact difficulties, social network features and leisure activities. By means of a discriminant analysis 83% of the subjects could be correctly classified. In a study of perceived parental rearing, depressives showed to have experienced lack of emotional warmth. As regards social class an overrepresentation of social class III in the subgroups of unipolar, bipolar and unspecified depression was observed.Finally, implications for treatment are discussed in favour of a combination of drug and cognitive psychotherapy. Future research strategies are also suggested.
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