Family functioning and major depression: an overview.

The authors review the evidence supporting the idea that the family plays a major role in the development and course of major depression. They find that the family pathology evident during an acute depressive episode continues after the patient's remission; that the course of depressive illness, relapse rates, and suicidal behavior are all affected by family functioning; and that children of depressed parents are at high risk for psychopathology. The authors explore unresolved issues regarding our understanding of the factors mediating the interaction between major depression and family functioning, concluding that there is evidence to support family and marital interventions, particularly in the treatment of depressed women.

[1]  M M Weissman,et al.  The assessment of social adjustment. A review of techniques. , 1975, Archives of general psychiatry.

[2]  I. Glick,et al.  Inpatient family intervention: a randomized clinical trial. II. Results at hospital discharge. , 1988, Archives of general psychiatry.

[3]  E. Gershon,et al.  The Family Attitudes Questionnaire. Patients' and spouses' views of bipolar illness. , 1981, Archives of general psychiatry.

[4]  M. Weissman,et al.  Epidemiology of affective disorders. A reexamination and future directions. , 1981, Archives of general psychiatry.

[5]  A. Roy Five Risk Factors for Depression , 1987, British Journal of Psychiatry.

[6]  R. Alnæs,et al.  Personality and personality disorders among patients with major depression in combination with dysthymic or cyclothymic disorders * , 1989, Acta psychiatrica Scandinavica.

[7]  K. Merikangas Divorce and assortative mating among depressed patients. , 1984, The American journal of psychiatry.

[8]  E. M. Cummings,et al.  Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. , 1985, Child development.

[9]  M. Blehar,et al.  Family and genetic studies of affective disorders. , 1988, Archives of general psychiatry.

[10]  G. Keitner,et al.  Family functioning and the course of major depression. , 1987, Comprehensive psychiatry.

[11]  W. Lancee,et al.  Social Support and Post Hospital Outcome for Depressed Women * , 1983, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[12]  K. Merikangas,et al.  Children of depressed parents. Increased psychopathology and early onset of major depression. , 1987, Archives of general psychiatry.

[13]  D. Kupfer,et al.  Marital adjustment in major depression. , 1985, Journal of affective disorders.

[14]  P. Bebbington Marital status and depression: A study of English national admission statistics , 1987, Acta psychiatrica Scandinavica.

[15]  N. Bouras,et al.  Marital problems in chronically depressed and physically ill patients and their spouses. , 1986, Comprehensive psychiatry.

[16]  G. Keitner,et al.  Family functioning, social adjustment, and recurrence of suicidality. , 1990, Psychiatry.

[17]  D. Hooper,et al.  A Study of the Interaction Between Depressed Patients and Their Spouses , 1975, British Journal of Psychiatry.

[18]  M. Weissman,et al.  Marital disputes and treatment outcome in depressed women. , 1979, Comprehensive psychiatry.

[19]  P. Lavori,et al.  Recovery in major depressive disorder: analysis with the life table and regression models. , 1982, Archives of general psychiatry.

[20]  I. Glick,et al.  A controlled evaluation of inpatient family intervention. I. Preliminary results of the six-month follow-up. , 1985, Archives of general psychiatry.

[21]  D. Black,et al.  The importance of Axis II in patients with major depression. A controlled study. , 1988, Journal of affective disorders.

[22]  J. Crowther The Relationship between Depression and Marital Maladjustment A Descriptive Study , 1985, The Journal of nervous and mental disease.

[23]  C. Hammen,et al.  Observations of interactions of depressed women with their children. , 1989, The American journal of psychiatry.

[24]  G. Brody,et al.  The relationship between parental depressive mood states and child functioning , 1987 .

[25]  J. Leff,et al.  The Influence of Family and Social Factors on the Course of Psychiatric Illness , 1976, British Journal of Psychiatry.

[26]  I. Gotlib,et al.  Depression and marital functioning: an examination of specificity and gender differences. , 1989, Journal of abnormal psychology.

[27]  J. Leff,et al.  The measurement of expressed emotion in the families of psychiatric patients. , 1976, The British journal of social and clinical psychology.

[28]  H. Locke,et al.  SHORT MARITAL ADJUSTMENT AND PREDICTION TESTS: THEIR RELIABILITY AND VALIDITY , 1959 .

[29]  J. Birtchnell Depression and Family Relationships , 1988, British Journal of Psychiatry.

[30]  A. Biglan,et al.  Home observations of family interactions of depressed women. , 1987, Journal of consulting and clinical psychology.

[31]  A. S. Friedman Interaction of drug therapy with marital therapy in depressive patients. , 1975, Archives of general psychiatry.

[32]  G. Keitner,et al.  Family functioning and suicidal behavior in psychiatric inpatients with major depression. , 1987, Psychiatry.

[33]  Lawrence M. Baldwin,et al.  THE McMASTER FAMILY ASSESSMENT DEVICE , 1983 .

[34]  G. Keitner,et al.  Family functioning in the families of psychiatric patients. , 1986, Comprehensive psychiatry.

[35]  D. Spiegel,et al.  Family environment as a predictor of psychiatric rehospitalization. , 1986, The American journal of psychiatry.

[36]  K. Kidd,et al.  Children and depression--the children of depressed parents; the childhood of depressed patients; depression in children. , 1980, Journal of affective disorders.

[37]  J. Teasdale,et al.  Levels of Expressed Emotion and Relapse in Depressed Patients , 1986, British Journal of Psychiatry.

[38]  D. Charney,et al.  Personality traits and disorder in depression. , 1981, The American journal of psychiatry.

[39]  G. Spanier Measuring Dyadic Adjustment: new scales for assessing the quality of marriage and similar dyads , 1976 .

[40]  D. Hooper,et al.  The melancholy marriage: an inquiry into the interaction of depression II. Expressiveness. , 1977, The British journal of medical psychology.

[41]  P. Lavori,et al.  Impact of severity and chronicity of parental affective illness on adaptive functioning and psychopathology in children. , 1986, Archives of general psychiatry.

[42]  G. Keitner,et al.  Compounded depression and family functioning during the acute episode and at 6-month follow-up. , 1989, Comprehensive psychiatry.

[43]  G. Klerman,et al.  Long-term outcome of episodes of major depression. Clinical and public health significance. , 1984, JAMA.

[44]  P. Bebbington,et al.  Caring and its Burdens , 1987, British Journal of Psychiatry.

[45]  R. Moos,et al.  Comparisons of children of depressed and nondepressed parents: A social-environmental perspective , 1983, Journal of abnormal child psychology.

[46]  C. Zahn-Waxler,et al.  Child-rearing patterns in depressed, abusive, and normal mothers. , 1985, The American journal of orthopsychiatry.

[47]  M. Weissman,et al.  The course of marital disputes in depressed women: a 48-month follow-up study. , 1980, Comprehensive psychiatry.

[48]  P. Mclean,et al.  A behavioral approach to the treatment of depression , 1973 .

[49]  C. Hammen,et al.  Maternal affective disorders, illness, and stress: risk for children's psychopathology. , 1987, The American journal of psychiatry.

[50]  E. Menaghan Depressive Affect and Subsequent Divorce , 1985 .

[51]  E. Waring,et al.  Intimacy and Emotional Illness in the General Population * , 1981, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[52]  R. Moos,et al.  Children of parents with unipolar depression: A controlled 1-year follow-up , 1986, Journal of abnormal child psychology.

[53]  K. Merikangas,et al.  Parental concordance for affective disorders: psychopathology in offspring. , 1988, Journal of affective disorders.

[54]  R. Cadoret,et al.  Genetic and environmental factors in major depression. , 1985, Journal of affective disorders.

[55]  R. Corney Marital Problems and Treatment Outcome in Depressed Women , 1987, British Journal of Psychiatry.

[56]  M. Keller,et al.  "Double depression": superimposition of acute depressive episodes on chronic depressive disorders. , 1982, The American journal of psychiatry.

[57]  I. Glick,et al.  A randomized clinical trial of inpatient family intervention, III: Effects at 6-month and 18-month follow-ups. , 1988, The American journal of psychiatry.

[58]  G. Klerman,et al.  Children of parents with major affective disorder: a review. , 1983, The American journal of psychiatry.

[59]  I. Gotlib,et al.  Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. , 1988, Psychological bulletin.

[60]  J. Teasdale,et al.  Predictors of relapse in unipolar depressives: expressed emotion, marital distress, and perceived criticism , 1989 .

[61]  D. Snyder,et al.  Empirical validation of the Marital Satisfaction Inventory: an actuarial approach. , 1981, Journal of consulting and clinical psychology.

[62]  R. Kessler,et al.  Living with a depressed person. , 1987, Journal of consulting and clinical psychology.

[63]  K. Dobson Marital and social adjustment in depressed and remarried women. , 1987, Journal of clinical psychology.

[64]  D. Aldridge Family interaction and suicidal behaviour: a brief review , 1984 .

[65]  G. Brown,et al.  Psychiatric disorder in a rural and an urban population: 2. Sensitivity to loss , 1981, Psychological Medicine.

[66]  J. Richman Symbiosis, empathy, suicidal behavior, and the family. , 1978, Suicide & life-threatening behavior.

[67]  R. Moos,et al.  Life stressors, social resources, coping, and the 4-year course of unipolar depression. , 1989, Journal of abnormal psychology.

[68]  P. McGuffin,et al.  The Genetics of Depression and Manic-Depressive Disorder , 1989, British Journal of Psychiatry.

[69]  S. Beach,et al.  The treatment of depression occurring in the context of marital discord , 1986 .