Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T18:56:36.690Z Has data issue: false hasContentIssue false

Diagnosis, Personality and the Long-term Outcome of Depression

Published online by Cambridge University Press:  02 January 2018

Gavin Andrews*
Affiliation:
Clinical Research Unit for Anxiety Disorders, The University of New South Wales at St Vincent's Hospital, Sydney
Megan Neilson
Affiliation:
Clinical Research Unit for Anxiety Disorders, St Vincent's Hospital, Sydney
Caroline Hunt
Affiliation:
Clinical Research Unit for Anxiety Disorders, The University of New South Wales
Gavin Stewart
Affiliation:
Clinical Research Unit for Anxiety Disorders, The University of New South Wales
L. G. Kiloh
Affiliation:
The University of New South Wales
*
Clinical Research Unit for Anxiety Disorders, 299 Forbes St, Darlinghurst, NSW 2010, Australia

Abstract

Patients diagnosed in the late 1960s as suffering from either endogenous or neurotic depression, or as presenting with depression but discharged with another neurotic diagnosis, were followed for 15 years. Diagnosis at index admission did not predict overall outcome, but patients with endogenous depression, an apparently stable diagnosis, had longer index admissions, were readmitted sooner, but spent less time ill than patients in either of the neurosis groups. Personality abnormality accounted for 20% of the variance in outcome in the neurotic groups and only 2% of the variance in the endogenous group. Thus there is evidence that endogenous and neurotic depression are two illnesses and that, in the neuroses particularly, prognosis will depend on the extent to which these personality abnormalities are modified by treatment.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G. (1981) A prospective study of life events and psychological symptoms. Psychological Medicine, 77, 795801.CrossRefGoogle Scholar
Andrews, G. (1989) Private and public psychiatry: a comparison of two health care systems. American Journal of Psychiatry, 146, 881886.Google Scholar
Andrews, G., Kiloh, L. G. & Neilson, M. (1973) Patterns of depressive illness: the compatability of disparate points of view. Archives of General Psychiatry, 29, 670673.CrossRefGoogle ScholarPubMed
Andrews, G., Kiloh, L. G. & Kehoe, L. (1978) Asthenic personality, myth or reality. Australian and New Zealand Journal of Psychiatry, 12, 9598.Google Scholar
Andrews, G. & Hadzi-Pavlovic, D. (1988) The work of Australian psychiatrists, circa 1986. Australian and New Zealand Journal of Psychiatry, 22, 153165.Google Scholar
Andrews, G. & Moran, C. (1988) The treatment of agoraphobia with panic attacks: are drugs essential? In Panic and Phobias II. Treatments and Variables Affecting Course and Outcome (eds I. Hand & H. U. Wittchen). Heidelberg: Springer-Verlag.Google Scholar
Andrews, G., Stewart, G., Morris-Yates, A., et al (1990) Evidence for a general neurotic syndrome. British Journal of Psychiatry, 157, 612.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et at (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659674.Google Scholar
Cattell, R. B. & Scheier, I. H. (1963) Handbook for the IPAT Anxiety Scale Questionnaire (2nd edn). Champaign, Illinois: Institute for Personality and Ability Testing.Google Scholar
Charney, D. S., Nelson, J. C. & Quinlan, D. M. (1981) Personality traits and disorder in depression. American Journal of Psychiatry, 138, 16011604.Google ScholarPubMed
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory. London: University of London Press.Google Scholar
Grinker, R. R., Miller, J., Sabshin, M., et al (1961) The Phenomena of Depressions. New York: Harper & Row.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.Google Scholar
Henderson, A. S., Byrne, D. G. & Duncan-Jones, P. (1981) Neurosis and the Social Environment. Sydney: Academic Press.Google Scholar
Hirschfeld, R. M. A., Klerman, G. L., Andreasen, N. C., et al (1986) Psychosocial predictors of chronicity in depressed patients. British Journal of Psychiatry, 148, 648654.Google Scholar
Joreskog, K. G. & Sorbom, D. (1988) Lisrel 7: A Guide to the Program and Applications. Chicago: SPSS Inc.Google Scholar
Kendell, R. E. (1968) The Classification of Depressive Illnesses. London: Oxford University Press.Google Scholar
Kendell, R. E. & Discipio, W. J. (1968) Eysenck personality inventory scores of patients with depressive illnesses. British Journal of Psychiatry, 114, 767770.Google Scholar
Kiloh, L. G. & Garside, R. F. (1963) The independence of neurotic depression and endogenous depression. British Journal of Psychiatry, 109, 451463.Google Scholar
Kiloh, L. G., Andrews, G., Neilson, M., et al (1972) The relationship of the syndromes called endogenous and neurotic depression. British Journal of Psychiatry, 121, 183196.Google Scholar
Kiloh, L. G., Andrews, G., Neilson, M., et al (1974) The influence of diagnosis on the treatment of depressed patients. In Depression in Everyday Practice (ed. P. Keilholtz). Berne: Hans Huber.Google Scholar
Kiloh, L. G., Andrews, G., Neilson, M., et al (1988) The long-term outcome of depressive illness. British Journal of Psychiatry, 153, 752757.Google Scholar
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741751.CrossRefGoogle ScholarPubMed
Lewis, G. & Appleby, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 4449.Google Scholar
McGlashan, T. H. (1987) Borderline personality disorder and unipolar affective disorder. Long-term effects of comorbidity. Journal of Nervous and Mental Disease, 175, 467473.Google Scholar
Paykel, E. S., Klerman, G. L. & Prusoff, B. A. (1976) Personality and symptom pattern in depression. British Journal of Psychiatry, 129, 327334.Google Scholar
Pilkonis, P. A. & Frank, E. (1988) Personality pathology in recurrent depression: nature, prevalence, and relationship to treatment response. American Journal of Psychiatry, 145, 435441.Google Scholar
Weissman, M. M., Prusoff, B. A. & Klerman, G. L. (1978) Personality and the prediction of long-term outcome of depression. American Journal of Psychiatry, 135, 797800.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.