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Heterogeneity of Depression

Classification of Depressive Subtypes by Longitudinal Course

Published online by Cambridge University Press:  02 January 2018

Kathleen Ries Merikangas ,
Werner Wicki  and
Jules Angst
Kathleen Ries Merikangas*
Affiliation:
Yale University School of Medicine, Departments of Psychiatry and Epidemiology, and Genetic Epidemiology Research Unit, 40 Temple Street, Lower Level, New Haven, Connecticut 06510-3223
Werner Wicki
Affiliation:
Research Department, Psychiatric University Hospital, PO Box 68, 8029 Zurich, Switzerland (now at University of Basel, Switzerland)
Jules Angst
Affiliation:
Research Department, Psychiatric University Hospital, 8029 Zurich, Switzerland
*
∗Correspondence
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Abstract

This paper describes the application of prospective longitudinal data from an epidemiological sample of young adults to define subtypes of major depression. Depression was classified on a spectrum from subthreshold manifestation of symptoms and duration at one end, to cases with recurrent episodes of depression meeting duration criteria for major depressive episodes at the other. There was a direct relationship between the severity of depression over the longitudinal course and both duration and recurrence of depressive episodes. The subgroup of depression with recurrence of both brief and longer duration episodes could be discriminated on most of the indicators of validity including symptoms, impairment, family history, and suicide attempts. In light of the young age of this cohort, the strong history of suicide attempts and other complications of depression among the subjects with recurrent depression was striking. These findings underscore the importance of employing course as a classification criterion of depression, and the inclusion of subthreshold episodes of depression in the characterisation of course.

Type
Peer Review
Information
The British Journal of Psychiatry , Volume 164 , Issue 3 , March 1994 , pp. 342 - 348
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Akiskal, H. S., Cassano, G. B., Musetti, L., et al (1989) Psychopathology, temperament, and past course in primary major depressions. I. Review of evidence for a bipolar spectrum. Psychopathology, 22, 268–277.Google Scholar
Angst, J. (1988) Clinical course of affective disorders. In Depressive illness: Prediction of course and outcome (eds T. Helgason & R. J. Daly), pp. 1–48. Berlin: Springer.Google Scholar
Angst, J. (1990) Natural history and epidemiology of depression: Results of community studies. In Prediction and Treatment of Recurrent Depression (eds J. Cobb & L. M. Goeting), pp. 1–11. Duphar Medical Relations.Google Scholar
Angst, J. (1993a) Course as classifier of depression. In Recurrent Mood Disorders. New Perspectives in Therapy, vol. 8 (ed. Placidi, G. F.), pp. 67–78. Bangalore: Macmillan India.Google Scholar
Angst, J. (1993b) Recurrent brief depression. In Research in Mood Disorders: an Update (eds H. Hippius & C. Stephanis with F. Müller-Spahn), pp. 17–30. Berne: Hogrefe and Huber.Google Scholar
Angst, J. & Dobler-Mikola, A. (1985) The Zurich study: A prospective epidemiological study of depressive, neurotic, and psychosomatic syndromes. IV. Recurrent and nonrecurrent brief depression. European Archives of Psychiatry and Neurological Sciences, 234, 408–416.Google Scholar
Angst, J. & Dobler-Mikola, A. & Binder, J. (1984) The Zurich study: A prospective epidemiological study of depressive, neurotic, and psychosomatic syndromes. I. Problem methodology. European Archives of Psychiatry and Neurological Sciences, 234, 13–40.CrossRefGoogle ScholarPubMed
Angst, J. & Wicki, W. (1991) The Zurich Study. XI. Is dysthymia a separate form of depression? Results of the Zurich cohort study. European Archives of Psychiatry and Neurological Sciences, 240, 349–354.Google ScholarPubMed
Bland, R. C. & Orn, H. (1982) Course and outcome in affective disorders. Canadian Journal of Psychiatry, 27, 573–578.CrossRefGoogle ScholarPubMed
Cassano, G. B., Akiskal, H. S., Musetti, L., et al (1989) Psychopathology, temperament, and past course in primary major depressions. 2. Toward a redefinition of bipolarity with a new semi-structured interview for depression. Psychopathology, 22, 278–288.Google Scholar
Coryell, W. & Winokur, G. (1982) Course and outcome. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp. 93–106. Edinburgh: Churchill Livingstone.Google Scholar
Derogatis, L. R. (1977) SCL–90. Administration, Scoring and Procedures Manual–I for the R (Revised) Version and Other Instruments of the Psychopathology Rating Scales Series. Johns Hopkins University, School of Medicine, Chicago, Illinois.Google Scholar
Duncan, D. B. (1975) T-Tests and intervals for comparisons suggested by the data. Biometrics, 31, 339–359.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Fichter, M. M., Rehm, J., Witzke, W., et al (1988) Der Verlauf affektiver und psychosomatischer Strörungen am Beispiel der oberbayerischen Felstudie: Ein lineares Kausalmodell verlaufsbeeinflussender Faktoren. In Affektive Störungen. Diagnostische, Epidemiologische, Biologische und Therapeutische Aspekte (eds D. von Zersson & H. G. Moller), pp. 84–98. Berlin: Springer.Google Scholar
Fukuda, K., Etoh, T., Iwadate, T., et al (1983) The course and prognosis of manic-depressive psychosis: A quantitative analysis of episodes and intervals. Tohoku Journal of Experimental Medicine, 139, 199–307.CrossRefGoogle ScholarPubMed
Kahlbaum, J. (1874) Die Katatonie oder das Spannungsirresein. Eine Klinische Form Psychischer Krankheiten. Berlin: Hirschwald.Google Scholar
Kraepelin, E. (1899) Psychiatrie. Ein Lehrbuch fur Studierende und Aerzte (6th edn). Leipzig: Barth.Google Scholar
Murphy, G. E., Woodruff, R. A. & Herjanic, M. (1974) Primary affective disorder. Selection efficiency of two sets of diagnostic criteria. Archives of General Psychiatry, 31, 181–184.CrossRefGoogle ScholarPubMed
Reinhardt, P. & Winston, (1985) SAS User's Guide: Statistics. Version 5. SAS Institute, Cary, North Carolina.Google Scholar
Rorsman, B., Grasbeck, A., Hagnell, O., et al (1990) A prospective study of first-incidence depression. The Lundby study, 1957–72. British Journal of Psychiatry, 156, 336–342.CrossRefGoogle ScholarPubMed
Sargent, J. K., Bruce, M. L., Florio, L., et al (1990) Factors associated with one year outcome of major depression in the community. Archives of General Psychiatry, 47, 519–526.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria. Rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Surtees, P. G., Sahidharan, S. P. & Dean, C. (1986) Affective disorder amongst women in the general population: A longitudinal study. British Journal of Psychiatry, 148, 176–186.Google Scholar
Winter, P., Philipp, M., Buller, R., et al (1991) Identification of minor affective disorders and implications for psychopharmacotherapy. Journal of Affective Disorders, 22, 125–133.Google Scholar
Wittchen, H-U. & von Zerssen, D. (1987) Verlaufe behandelter und unbelhandlter Depression und Angststrungen. Eine Klinisch Psychiatrische und Epidemiologische Verlaufsuntersuchung. Berlin: Springer.Google Scholar
Zis, A. P. & Goodwin, F. K. (1979) Major affective disorders as a recurrent illness. Archives of General Psychiatry, 36, 835–839.Google Scholar
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