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Dimensions de la dépression : modèles statistiques pour l’évaluation des troubles affectifs

Published online by Cambridge University Press:  28 April 2020

P. Bech*
Affiliation:
Frederiksborg General Hospital, 48, Dyrehavevej3400, Hillerod, Danemark
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Résumé

Dans cette étude, les dimensions de la dépression ont été analysées par rapport aux états dépressifs non bipolaires. Les états d’anxiété dans ce domaine ont été considérés comme des formes peu sévères de dépression au niveau phénoménologique. La dimension de l’anhédonie a été considérée comme liée aux troubles schizoaffectifs.

Le concept clinique de la mélancolie a été utilisé pour inclure ces états unipolaires de la dépression. Ce concept comprend et la dimension de sévérité et les types diagnostiques de la dépression. Le principe d’organisation des désordres mentaux utilisé dans le manuel du DSM III implique que la «phénoménologie partagée» précède l’étiologie psychologique dans le cadre des désordres affectifs.

Certains auteurs soutiennent que le moyen le plus efficace de tester la «phénoménologie partagée» est de démontrer l’existence d’une relation additive entre indices et symptômes. Le modèle de Rasch consiste en une théorie générale de la relation statistique entre les dimensions cliniques et les échelles d’évaluation de la dépression.

Moyennant l’usage des analyses de Rasch, on a démontré que notre échelle de la mélancolie mesure une dimension de la sévérité de la dépression. De plus, notre échelle diagnostique de la mélancolie, qui a été élaborée à partir des 2 échelles de Newcastle (pour la dépression endogène versus la dépression réactionnelle (névrotique), mesure ces deux dimensions diagnostiques. Des résultats préliminaires obtenus avec l’échelle de diagnostic de la mélancolie ont démontré que chez des patients classifiés comme ayant une dépression endogène «pure» la courbe d’amélioration dans le temps est plus importante que chez des patients classifiés comme ayant une dépression réactive «pure» ou une association de dépression endogène et de dépression réactionnelle.

Summary

Summary

In this overview the dimensions in depression have been analysed for non-bipolar states of depression. In this area, states of anxiety have been considered as mild forms of depression at the phenomenological level. The dimension of anhedonia has been considered as related to schizo-affective disorders.

The clinical concept of melancholia has been used to cover these unipolar states of depression. This concept includes both the dimension of severity and diagnostic types of depression. The organization principle of mental disorders used in DSM III implies that «shared phenomenology» precedes «psychological aetiology» within affective disorders.

It has been argued that the most adequate tool for testing «shared phenomenology» is to demonstrate an additive relationship between signs and symptoms. This approach refers to phenomenological dimensions. The Rasch model is a general theory of the statistical relationship between clinical dimensions and rating scales. By use of Rasch analyses it has been shown that our Melancholia Scale is measuring a dimension of severity of depression. Furthermore, our Diagnostic Melancholia Scale (which is derived from the two Newcastle Scales) for endogenous versus reactive (neurotic) depression is measuring these two diagnostic dimensions. Preliminary results with the Diagnostic Melancholia Scale have shown that patients classified as «pure» endogenous depression have a more time-dependent improvement curve than patients classified as «pure» reactive depression or as combined endogenous and reactive depression.

Type
Research Article
Copyright
Copyright © European Psychiatric Association 1998

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References

Références

American, Psychiatric Association (1980) Diagnostic and Statistical Matinal of Mental Disorders (DSM- III). American Psychiatric Association, Washington DCGoogle Scholar
Andreasen, N.C., Grove, W.M. & Manier, R. (1980) Cluster analysis and the classification of depression. Br. J. Psychiatry 137, 25626510.1192/bjp.137.3.256CrossRefGoogle ScholarPubMed
Bech, P. (1981) Rating scales for affective disorders: their validity and consistency. Acta Psychiatr. Scand. 64 (suppl. 295), 1101Google Scholar
Bech, P. (1987) The concept of minor endogenous depression. Br. J. Psychiatry 151, 27110.1192/S0007125000283918CrossRefGoogle Scholar
Bech, P. & Rafaelsen, O.J. (1980) The use of rating scales exemplified by a comparison of the Hamilton and the Bech-Rafaelsen Melancholia Scale. Acta Psychiatr. Scand. 62 (suppl. 285), 128131CrossRefGoogle Scholar
Bech, P. & Allerup, P. (1986) A categorical approach to depression by a three-dimcnsional System. Psychopathology 19, 32733910.1159/000284457CrossRefGoogle ScholarPubMed
Bech, P., Gram, L.F., Reisby, N. & Rafaelsen, O.J. (1980) The WHO Depression Scale: relationship to the Newcastle Scales. Acta Psychiatr. Scand. 62, 140153CrossRefGoogle ScholarPubMed
Bech, P., Allerup, P., Gram, L.F., Reisby, N., Rosenberg, R., Jacobsen, O. & Nagy, A. (1981) The Hamilton Depression Scale. Evaluation of objectivity using logistic models. Acta Psychiatr. Scand. 63, 290299CrossRefGoogle ScholarPubMed
Bech, P., Gjerris, A., Andersen, J., Bøjholm, S., Kramp, P., Bolwig, T.G., Kastrup, M., Clemmesen, L. & Rafaelsen, O.J. (1983) The Melancholia Scale and the Newcastle Scale. Br. J. Psychiatry 143, 5863CrossRefGoogle Scholar
Bech, P., Kastrup, M. & Rafaelsen, O.J. (1986) Minicompendium of rating scales for States of anxiety, depression, mania, schizophrenia with corresponding DSM III syndromes. Acta Psychiatr. Scand. 73 (suppl. 326), 137Google Scholar
Bech, P., Kastrup, M. & Loldrup, D. (1986) Use of headache rating scales: a multiaxial approach. Cephalalgia 6, 698010.1046/j.1468-2982.1986.0602069.xCrossRefGoogle ScholarPubMed
Bech, P., Allerup, P., Gram, L.F., Kragh-Sørenseti, P., Rafaelsen, O.J., Reisby, N., Vestergaard, P. & Duag, M. (1988) The Diagnostic Melancholia Scale (DMS): dimensions of endogenous and reactive depression with relationship to the Newcastle Scales. J. Affective Disord. 14, 161170CrossRefGoogle ScholarPubMed
Cantor, N., Smith, E.E., French, R.S. & Mezzich, J. (1980) Psychiatric diagnosis as prototype categorization. J. Ahnonn. Psychol. 89, 181193Google ScholarPubMed
Carney, M.W.P., Roth, M. & Garside, R.F. (1965) The diagnosis of depressive syndromes and prediction of ECT response. Br. J. Psychiatry 111, 65967410.1192/bjp.111.477.659CrossRefGoogle Scholar
Eysenck, H.J. (1970) The classification of depressive Illness. Br. J. Psychiatry 117, 241250CrossRefGoogle Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. Tavistock, LondonGoogle Scholar
Guttman, L. (1944) A basis for scaling quantitative data. Am. Social. Rev. 9, 139150CrossRefGoogle Scholar
Hamilton, M. (1959) The assessment of anxiety States by rating. Br. J. Med. Psychol. 32, 5055CrossRefGoogle ScholarPubMed
Hamilton, M. (1960) A rating scale for depression. J. Neurosurg. Psychiatry 23, 566210.1136/jnnp.23.1.56CrossRefGoogle ScholarPubMed
Hamilton, M. & White, G.M. (1959) Clinical syndromes in depressive States. J. Ment. Sci. 105, 98599810.1192/bjp.105.441.985CrossRefGoogle ScholarPubMed
Kendell, R.E. (1968) The Classification of Depressive lllness. Oxford University Press, LondonGoogle Scholar
Maier, W. & Philipp, M. (1985) Comparative analysis of observer depression scale. Acta Psychiatr Scand 72, 23924510.1111/j.1600-0447.1985.tb02601.xCrossRefGoogle Scholar
Maier, W., Buller, R., Philipp, M. & Heuser, I. (1988) The Hamilton Anxiety Scales. Reliability, validity and sensitivity to change in anxiety and depressive disorders. J. Affective Disord. 14, 6168CrossRefGoogle ScholarPubMed
Mendels, J. & Cochrane, C. (1968) The nosology of depression. The endogenous-reactive concept. Am. J. Psychiatry 124, 1 - 1110.1176/ajp.124.11S.1CrossRefGoogle ScholarPubMed
Paykel, E.S. (1971) Classification of depresscd patients: A cluster analysis derived grouping. Br. J. Psychiatry 118, 275 -288CrossRefGoogle ScholarPubMed
Paykel, E.S. (1981) Have multivariate statistics contributed to classification? Br. J. Psychiatry 139, 357362CrossRefGoogle ScholarPubMed
Pilowsky, I., Levine, S. & Boulton, D.M. (1969) The classification of depression by numerical taxonomy. Br. J. Psychiatry 115, 937945CrossRefGoogle ScholarPubMed
Raskin, A. & Crook, T.H, (1976) The endogenousneurotic distinction as a perdictor of response to antidepressant drugs. Psychol. Med. 6, 597010.1017/S0033291700007509CrossRefGoogle ScholarPubMed
Roth, M., Gurney, C. & Mountjoy, C.Q. (1983) The Newcastle rating scales. Acta Psychiatr. Scand. 68 (suppl. 310) 4254CrossRefGoogle ScholarPubMed
Skottowe, I. (1953) Clinical Psychiatry for Practitioners and Students. Eyre and Spottiswoode, LondonGoogle Scholar
Suchman, E.A. (1950) The utility of scalogram analysis. In: Measurement and Prediction (Stouffer, S.A., Guttman, L., Suchman, E.A., Lazarsfeld, P.F., Starr, S.S. & Clausen, J.A., eds.) Princeton University Press, Princeton, pp. 122171Google Scholar
World, Health Organization (1974) Glossary of Mental Disorders and Guide to their Classification for Use in Conjonction with the International Classification of Diseases. Eight Revision. World Health Organization, GenevaGoogle Scholar
World, Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Nintli Revision of the International Classification of Diseases. World Health Organization, GenevaGoogle Scholar
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