DefinePK

Abstract

Introduction


The life time risk of an individual developing a depressive episode now approaches 15%. 1 The World Health Organisation ranks depression as the world\'s fourth greatest public health problem 2 with an expected certain increase in the burden in future. 3 Women are said to have a 1.7 times life time risk of developing a major episode in United States 1 ; a greater than twice male to female ratio has been reported in Pakistan. 4,5 Many ailments are self-limiting and improve with time irrespective of treatment 6 and this change is called spontaneous remission or in statistical terms regression to the mean. Rearchers have tried to explore the factors that influence this phenomenon. For anxiety and depression severity of the initial episode, duration of depression 2 and a passive dependent personality trait 7 are reported as barriers to spontaneous recovery. Goldberg et al studied certain social and personality factors that help a person in recovering from anxiety and depression and termed these \'factors for restitution\'. 8 The extent of influence of adverse life events/stressors on remission is still open to debate 7 though it is reported that, there is a difference in recovery between those who suffer from adverse life events/stressors and those who do not inspite of adequate treatment. 9 Community based studies in various regions of Pakistan have reported figures for depression in women varying from 66% in rural Punjab5 to 30% in semi-urban Karachi.l0 The health services in Pakistan are ill equipped in terms of resources to deal with this burden, and factors of vulnerability and restitution need to be explored in order to prevent/minimize morbidity from anxiety and/or depression. This paper analyzes these factors in a group of women who made a spontaneous remission/recovery from anxiety and/or depression.