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Cited by 16Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and DisordersTreatment of Major Depression

Depressive symptoms and disorders, levels of functioning and psychosocial stress: an integrative hypothesis

Patten, S.B.·1999·Medical Hypotheses
DOI 10.1054/mehy.1998.0747
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Abstract

The objective of this manuscript is to propose an integrative conceptual model linking depressive disorders and depressive symptoms. Existing conceptual models of depression etiology tend to make this distinction in an arbitrary way. For example, in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), there is a requirement that severe and persistent depressive symptoms be present for a period of two weeks or more before the depressive syndrome qualifies as a major depressive disorder. The concept of psychosocial stress is a potentially unifying concept relating depressive symptoms to disorders, as stress is a risk factor for both depressive symptoms and depressive disorders. Furthermore, a key feature of the depressive disorders is that they are associated with psychosocial dysfunction, which may be conceptualized as an inability to adapt to environmental stress. The hypothesis presented here is that subclinical depressive symptoms represent an adaptive biological response pattern to psychosocial stress, fostering adaptation in the face of a changing (stressful) environment. However, when a threshold of symptom severity is exceeded, the depressive syndrome becomes maladaptive, impairing adaptation to environmental stress and leading to an accumulation of stressful circumstances and experiences. As such, a vicious cycle may be created, leading, perhaps, to the occurrence of a depressive disorder.

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  • Evidence that depression increases the risk for functional decline independent of the presence or severity of medical illness suggests that somatic comorbidities do not fully explain the relationship between depressive symptoms and functional ability.

    “Evidence that depression increases the risk for functional decline independent of the presence or severity of medical illness (Ng, Niti, Zaw, and Kua 2009;Patten 1999;Steffens, Hays, and Krishnan 1999) further suggests that somatic comorbidities do not fully explain the relationship between depressive symptoms and functional ability.”

    From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Patten 1999

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Authors
Patten, S. B.
Affiliations
University of Calgary (CA)
Corresponding author
Patten, S.B.
ORCID
Patten, S.B.
Venue
Medical Hypotheses
Publisher
Elsevier BV
Published
1999-09
Volume
53
Issue
3
Pages
210-216
ISSN
0306-9877 (ISSN-L)
DOI
10.1054/mehy.1998.0747
OpenAlex
W2131277785
Cited by
16
References
26
Citations by year
2022: 3 · 2019: 1 · 2016: 1 · 2015: 1
FWCI
1.72
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Medical Hypotheses (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
depressive symptoms, depressive disorders, psychosocial stress, subthreshold depression, stress adaptation, maladaptive coping, vicious circle, etiology of depression, integrative conceptual model
MeSH terms
Adaptation, Psychological, Depression, Depressive Disorder, Humans, Models, Psychological, Stress, Psychological

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