Introduction: controversies old and new
Depression has been labelled the common cold of psychopathology. This comparison is unfortunate, for it conveys the impression of a frequent but mild complaint. In reality some depressions end fatally. Depression is responsible for the majority of suicide deaths; those most vulnerable to suicide are depressed and have lost hope (Minkoff, Bergman, Beck, A.T. & Beck, R., 1973; Wetzel, 1976). In many developed countries suicide is in the top ten most frequent causes of death and in younger, male cohorts, in the top three (see Chapter 3). Less easy to calculate, and only recently a subject of study, are those biological correlates of depression which appear to affect adversely immune system function (Farrant & Perez, 1989) and the capacity to combat physical disorder (e.g., via a cortisol – immune system feedback process). Moreover, depression may well reduce life expectancy in certain physical disorders, e.g., cancer (Whitlock & Siskind, 1979).