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The impact of familial personality disorder and alcoholism on the clinical features of depression

Published online by Cambridge University Press:  28 April 2020

C. VanValkenburg ,
S. Lilienfeld  and
H.S. Akiskal
C. VanValkenburg
Affiliation:
Minnesota Security Hospital, St Peter, Minnesota
S. Lilienfeld
Affiliation:
Department of Psychology, University of Minnesota, Minneapolis
H.S. Akiskal
Affiliation:
University of Tennessee, Memphis
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Summary

We compared patients with DSD or depression spectrum disease (family history positive for alcoholism or antisocial personality disorder in a first degree relative) to other depressives. DSD patients were likely to be diagnosed as having antisocial or borderline personality disorder, to be alcoholics, amphetamine abusers, or hysterics. They had more chronic depressive features, including hostility and self-pitying, bad-tempered, labile, and irritable mood, and they were nervous, worrisome, immature, overly dependent, and had tempestuous relationships. Their depressions were usually described as “reactive”, but their social outcomes were more likely to be poor.

Résumé

Résumé

Nous avons comparé des patients atteints d’un “trouble appartenant au spectre dépressif “(Dépressive spectrum Disease (DSD)) caractérisé par l’existence d’antécédents familiaux d’alcoolisme et de trouble de la personnalité antisociale chez les parents du premier degré, à d’autres groupes de patients.

Comme l’indique le tableau 7, le diagnostic de trouble de la personnalité antisociale ou borderline a été plus souvent attribué aux patients atteints d’“DSD”; c’est parmi eux que se compte le plus grand d’alcooliques, des toxicomanes aux amphétamines, et d’hystériques. Ces patients présentent davantage de manifestations dépressives durables marqués par l’hostilité et l’auto-apitoiement, ainsi que par la morosité, la labilité et l’irritabilité de l’humeur; ils sont par ailleurs nerveux, soucieux, immatures, hyperdépendants, et leurs relations inter-personnelles sont mouvementées. La dépression de ces patients est habituellement qualifié de “réactionnelle”; les possibilités d’insertion sociale plutôt réduites.

L’analyse discriminante directe, confirme que ces variations ne sont pas dues au hasard. 88.2 % des 220 patients de l’étude ont été correctement classés. Ce pourcentage atteint 90.2 % lorsque les patients alcooliques sont exclus. Dans l’analyse discriminante pas à pas les pourcentages sont très proches (tableaux 2 et 3). Les troubles anxieux ne sont pas corrélés significativement au DSD dans les analyses comparatives à une seule variabgle ; en revanche la survenue tardive d’attaques de panique secondaires à la dépression sont significativement corrélées au DSD dans la totalité de l’échantillon. Lorsque les patients alcooliques sont exclus, l’anxiété généralisée de survenue tardive devient le coefficient discriminant canonique standart le plus élevé. Les auteurs ont à nouveau vérifié, dans cette étude la validité de la conception de Winokur qui tend à assimiler la maladie à spectre dépressif à l’ancienne catégorie diagnostique de la dépression névrotique.

Keywords

Depressive Spectrum DiseaseAlcoolic disorderPersonality disorderGeneralized anxietyPanic attacksTrouble de spectre dépressifAlcoolismeTroubles de la personnalitéAnxiété généraliséeAttaques de panique
Type
Research Article
Information
Psychiatry and Psychobiology , Volume 2 , Issue 3 , 1987 , pp. 195 - 201
Copyright
Copyright © European Psychiatric Association 1987

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Footnotes

Address correspondence to: Dr. C. VanValkenburg, Correspondance à adresser au Minnesota Security Hospital, 100 Freeman Drive, St Peter, MN 56082, USA.

References

Akiskal, HS. - Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. Am J Psychiatry 1983; 140: 11-20.Google ScholarPubMed
Akiskal, HS., Bitar, A.H., Puzantian, V.R., Rosenthal, T.R., Walker, P.W. - The nosological status of neurotic depression - A prospective three- to four-year follow-up evaluation in light of the primary-secondary and unipolar-bipolar dichotomies. Arch Gen Psychiatry 1978; 35: 756-766.CrossRefGoogle Scholar
Akiskal, H.S., Rosentilal, T.L., Haykal, R.F., Lemmi, H, Rosenthal, R.H., Scott-Strauss, A. - Characterological depressions: Clinical and sleep EEG findings separating “subaffective dysthymias” from “character-spectrum” disorders. Arch Gen Psychiatry 1980; 37: 777-783.CrossRefGoogle ScholarPubMed
American Psychiatric Association- Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, American Psychiatric Association, Washington, DC 1980.Google Scholar
Andreasen, N.C., Winokur, G. - Newer experimental methods for classifying depression: a report from the NIMH collaborative pilot study. Arch Gen Psychiatry 1979; 36: 447-452.10.1001/archpsyc.1979.01780040089010CrossRefGoogle ScholarPubMed
Behar, D., Winokur, G., VanValkenburg, C., Lowry, M. - Clinical overlap among familial subtypes of unipolar depression. Neuropsychobiology 1981; 7: 179-184.10.1159/000117848CrossRefGoogle ScholarPubMed
Cadoret, R.J., Winokur, G., Dorzab, J., Baker, M. - Depressive disease: life events and onset of illness. Arch Gen Psychiatry 1972; 26: 133-136.10.1001/archpsyc.1972.01750200037008CrossRefGoogle ScholarPubMed
Cantwell, D.P. - Psychiatric illness in families of hyperactive children. Arch Gen Psychiatry 1972; 27: 414-417.CrossRefGoogle ScholarPubMed
Conger, A.J., Jackson, D.N. - Suppressor variables, prediction, and the interpretation of psychological relationships. Educ Psychol Measurement 1972; 32: 579-599.10.1177/001316447203200303CrossRefGoogle Scholar
Coryell, W., Zimmerman, M. - Outcome following ECT for primary unipolar depression: A test of newly proposed response predictors. Am J Psychiatry 1984; 141: 862-867.Google ScholarPubMed
Goodwin, D.W., Schulsinger, F., Knop, J., Mednick, S., Guze, S.B. - Psychopathology in adopted and nonadopted daughters of alcoholics. Arch Gen Psychiatry 1977; 34: 1005-1009.CrossRefGoogle Scholar
Hamilton, M., White, J.M. - Clinical syndromes in depressive States. J Ment Sci 1959; 105: 985-998.CrossRefGoogle ScholarPubMed
Kendell, R.E. - The classification of depression - A review of contemporary confusion. Br J Psychiatry 1976; 129: 15-29.CrossRefGoogle ScholarPubMed
Lewis, D.A., Kathol, R.G., Sherman, B.M., Winokur, G., Schlesser, M.A. - Differentiation of depressive subtypes by insulin insensitivity in the recovered phase. Arch Gen Psychiatry 1983; 40: 167-170.CrossRefGoogle ScholarPubMed
Lubin, A. - Some formulae for use with suppressor variables. Educ Psychol Measurernent 1957; 17: 286-296.CrossRefGoogle Scholar
Morrison, J.R., Stewart, M.A. - A family study of the hyperactive child syndrome. Biol Psychiatry 1971; 3: 189-195.Google ScholarPubMed
Nie, N.H., Hull, C.H., Jenkins, J.G., Steinbrenner, K., Bent, D.H. - Statistical Package for the Social Sciences, McGraw Hill, New York,675 p., 1975.Google Scholar
Overall, J.E., Hollister, L.E., Johnson, M.H., Pennington, V. - Nosology of depression and differential response to drugs. JAMA1966; 195: 946-948.CrossRefGoogle Scholar
Paykel, E.S. - Classification of depressed patients - A cluster analysis derived grouping. Br J Psychiatry 1972; 120: 147-156.CrossRefGoogle Scholar
Postel, J., Quetel, C., eds - Nouvelle Histoire de la Psychiatrie, Privat, Toulouse, pp. 357-360, 1983.Google Scholar
Robins, E., Guze, S. - Classification of affective disorders - The primary-secondary, endogenous-reactive and the neurotic-psychotic dichotomies, In: Williams, T.A., Katz, M.M., Shield, J.A. eds.: Recent Advances in Psychobiology of the Dépressive Illnesses, 283293, U.S. Government Printing Office, Washington, 1972.Google Scholar
Rosenthal, T.L., Akiskal, H.S., Scott-Strauss, A., Rosenthal, R.H.David, M. - Familial and developmental factors in characterological depressions. J Affective Disord 1981; 3: 183-192CrossRefGoogle ScholarPubMed
Rush, A.J., Giles, D.E., Roffwarg, H.P., Parker, C.R. - Sleep EEG and dexamethasone suppression test findings in outpatients with unipolar major depressive disorders. Biol Psychiatry 1982; 17: 327-341.Google ScholarPubMed
Vaillant, G.E. - The Natural History of Alcoholism, Harvard University Press, Cambridge, Massachusetts, 1983.Google Scholar
VanValkenburg, C., Akiskal, H.S., Puzantian, V.R. - Depression spectrum disease or character spectrum disorder? A clinical study of major depressives with familial alcoholisrn or sociopathy. Cornpr Psychiatry 1983; 24: 589-595.Google Scholar
VanValkenburg, C., Lowry, M.,Winokur G., Cadoret, R. - Depression spectrum disease vs pure depressive disease. J New Ment Dis 1977; 165: 341-347.10.1097/00005053-197711000-00005CrossRefGoogle ScholarPubMed
VanValkenburg, C., Winokur, G. - Depression spectrum disease, Psvehiatr Clin North Am 1979; 3: 469-482.10.1016/S0193-953X(18)30991-2CrossRefGoogle Scholar
Winokur, G. - Diagnostic and genetic aspects of affective illness. Psychiatry Ann 1973; 3: 6-15.Google Scholar
Winokur, G. - Unipolar depression - Is it divisible into autonomous subtypes?, Arch Gen Psychiatry 1979; 47-52.CrossRefGoogle Scholar
Winokur, G., Behar, D., VanValkenburg, C., Lowry, M. - Is a familial definition of depression both feasible and valid?.J New Ment Dis 1978; 166: 764-768.CrossRefGoogle ScholarPubMed
Winokur, G. - Unipolar depression - Is it divisible into autonomous subtypes? Arch Gen Psychiatry 1979; 36: 47-52.CrossRefGoogle ScholarPubMed
Winokur, G. - The validity of neurotic-reactive depression. New data and reappraisal - Arch Gen Psychiatry 1985; 42: 1116-1122.10.1001/archpsyc.1985.01790340100014CrossRefGoogle ScholarPubMed
Zimmerman, M., Coryell, W., Pfhol, B.M. - Importance of diagnostic thresholds in familial classification. Dexamethasone suppression test and familial subtypes of depression - Arch Gen Psychiatry 1985; 42: 300-304.10.1001/archpsyc.1985.01790260098012CrossRefGoogle ScholarPubMed
Zimmerman, M., Coryell, W., Pfohl, B. - Melancholic subtyping: a qualitative or quantitative distinction? Am J Psychiatry 1986; 143: 98-100.Google Scholar
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