February 1967

Life Events and Onset of Primary Affective DisordersA Study of 40 Hospitalized Patients and 40 Controls

Author Affiliations

St. Louis
From the Department of Psychiatry, Washington University School of Medicine, St. Louis.

Arch Gen Psychiatry. 1967;16(2):134-145. doi:10.1001/archpsyc.1967.01730200002002

CAN there be a cause-and-effect relationship between a stressful event in a person's life and the onset of a clinically serious and sustained affective disorder, mania, or depression which was not present before the event took place? This question has arisen repeatedly over the years, in part because of the apparent correspondence between the illnesses of depression and mania on the one hand, and the emotions of sadness and elation on the other. The latter, as transient mood states, can be triggered by events. If the illness depression is viewed as a kind of supersadness or the illness mania as superelation, then by extension one might assume that those discrete disorders can also be triggered by events. Making this assumption, physicians and patients alike often seek a causal connection between stressful events and sustained affective disorder. In an individual case it is impossible to prove or

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