Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T15:25:38.708Z Has data issue: false hasContentIssue false
  • English
  • Français

A study of depressive typologies using grade of membership analysis

Published online by Cambridge University Press:  09 July 2009

Jonathan Davidson ,
Max A. Woodbury ,
Susan Pelton  and
Ranga Krishnan
Jonathan Davidson*
Affiliation:
Department of Psychiatry and Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
Max A. Woodbury
Affiliation:
Department of Psychiatry and Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
Susan Pelton
Affiliation:
Department of Psychiatry and Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
Ranga Krishnan
Affiliation:
Department of Psychiatry and Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
*
1Address for correspondence: Dr Jonathan Davidson, De-partmeant of Psychiatry. V.A. Medical Center, Fulton Street, Durham, NC 27705, USA.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Grade of Membership (GOM) analysis, a multivariate technique for studying disease, was used to explore depressive typology and relationships between depression and anxiety. One hundred and ninety patients with RDC diagnoses of major or minor depression were assessed by the Hamilton and SCL-90 symptom rating scales, the Newcastle diagnostic indices for endogenous depression and for anxiety and depression. Demographic, family and treatment response information were used as external validators.

Five pure types provided the most satisfactory solution to these data. One group corresponded to classical melancholia, occurring in older, stable, in-patients, who lacked panic-phobic symptoms. All patients with agoraphobia fell into two distinct in-patient and out-patient groups, which differed from each other in several ways. In one group, a link was found between panic attacks, agitated melancholia and familial pure depression. The second group was less symptomatic and had more atypical vegetative symptoms.

Two more groups comprised mildly symptomatic, hypochondriacal, depression, and a highly neurotic, obsessive, anxious, non-phobic depression, which was commonly related to a physical stressor.

Type
Research Article
Information
Psychological Medicine , Volume 18 , Issue 1 , February 1988 , pp. 179 - 189
Copyright
Copyright © Cambridge University Press 1988

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

Andreasen, N. C., Grove, W. M. & Mauer, A. (1980). Cluster analysis and the classification of depression. British Journal of Psychiatry 137, 256–265.Google Scholar
Been, P. (1983). Ratings scales for affective disorders: their validity and consistency. Acta Psychiatrica Scandinavia 295 (Suppl. 64), 57.Google Scholar
Breier, A., Charney, D. & Heninger, G. R. (1984). Major depression in patients with agoraphobia and panic disorder. Archives of General Psychiatry 41, 1129–1135.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, 659–674.Google Scholar
Davidson, J. R. T. & Pelton, S. (1986). Forms of atypical depression and their response to antidepressant drugs. Psychiatry Research 17, 87–95.CrossRefGoogle ScholarPubMed
Davidson, J. R. T. & Turnbull, C. D. (1983). Isocarboxazid efficacy and tolerance. Journal of Affective Disorders 5, 183–189.Google Scholar
Davidson, J. R. T., McLeod, M. N., Turnbull, C. D. & Miller, R. D. (1981). A comparison of phenelzine and imipramine in depressed inpatients. Journal of Clinical Psychiatry 42, 295–297.Google Scholar
Davidson, J. R. T., Miller, R. D., Turnbull, C. D. & Sullivan, J. (1982). Atypical depression. Archives of General Psychiatry 39, 527–533.CrossRefGoogle ScholarPubMed
Davidson, J. R. T., Miller, R. D., Van Wykefleet, J.Manberg, P., Strickland, R. & Parrott, R. (1983). A double-blind evaluation of bupropion and amitriptyline in depressed inpatients. Journal of Clinical Psychiatry 44 (5) (Section 2), 114–116.Google Scholar
Davidson, J. R. T., Miller, R. D., Turnbull, C. D., Strickland, R. & Belyea, M. (1984). A two-dose evaluation of isocarboxazid in depression. Journal of Affective Disorders 6, 201–207.CrossRefGoogle Scholar
Derogatis, L. R., Lipman, R. S. & Covi, L. (1973). SCL-90: an outpatient psychiatric rating scale. Psycho-pharmacology Bulletin 9, 13–28.Google ScholarPubMed
Downing, R. W. & Rickels, K. (1974). Mixed anxiety-depression: fact or myth? Archives of General Psychiatry 30, 312–317.Google Scholar
Everitt, B. S. (1972). Cluster analysis: a brief discussion of some of the problems. British Journal of Psychiatry 120, 143–145.CrossRefGoogle ScholarPubMed
Gillespie, R. D. (1929). Clinical differentiation of types of depression. Guy's Hospital Reports 79, 306–344.Google Scholar
Gurney, C., Roth, M., Garside, R. F., Kerr, T. A. & Schapira, K. (1972). Studies in the classification of affective disorders: the relationship between anxiety states and depressive illness II. British Journal of Psychiatry 121, 162–166.Google Scholar
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6, 278–296.CrossRefGoogle ScholarPubMed
Kendell, R. E. (1976). Classification of depression: a review of contemporary confusion. British Journal of Psychiatry 129, 15–28.Google Scholar
Kiloh, L. G. & Garside, R. F. (1977). Depression: a multivariate study of Sir Aubrey Lewis's data on melancholia. Australian and New Zealand Journal of Psychiatry 11, 149–153.CrossRefGoogle ScholarPubMed
Leckman, J. F., Weissman, M. M., Merikangas, K. R., Pauls, D. L. & Prusoff, B. A. (1983). Panic disorder and major depression: increased risk of depression, alcoholism, panic and phobic disorders in families of depressed probands with panic disorder. Archives of General Psychiatry 40. 1055–1060.Google Scholar
Lewis, A. (1934). Melancholia: a clinical survey of depressive states. Journal of Mental Science 80, 277–378.Google Scholar
Manton, K. G., Siegler, I. C. & Woodbury, M. A. (1986). A study of frailty among the very old: methods for generating multivariate descriptions of progressive chronic diseases and functional decline. Journal of Gerontology (in the press).Google Scholar
Mapother, E. (1926). Discussion on manic-depressive psychosis. British Medical Journal 2, 872–876.Google Scholar
Mountjoy, C. Q. & Roth, M. (1982 a). Studies in the relationship between depressive disorders and anxiety states. Part I (rating scales). Journal of Affective Disorders 4, 127–147.CrossRefGoogle ScholarPubMed
Mountjoy, C. Q. & Roth, M. (1982 b). Studies in the relationship between depressive disorders and anxiety states. Part II (clinical items). Journal of Affective Disorders 4, 149–161.Google Scholar
Overall, J. E., Hollister, L. E., Johnson, M. H. & Pennington, V. E. (1966). Nosology of depression and differential response to drugs. Journal of the American Medical Association 195, 946–950.Google Scholar
Paykel, E. S. (1971). Classification of depressed patients: a cluster analysis derived grouping. British Journal of Psychiatry 118, 275–288.Google Scholar
Paykel, E. S. (1981). Have multivariate statistics contributed to classification? British Journal of Psychiatry 139, 357–362.CrossRefGoogle ScholarPubMed
Prusoff, B. A. & Klerman, G. L. (1974). Differentiating depressed from anxious neurotic outpatients. Archives of General Psychiatry 30, 302–309.Google Scholar
Raskin, A. & Crook, T. H. (1976). The endogenous-neurotic distinction as a predictor of response to antidepressant drugs. Psychological Medicine 6, 59–70.CrossRefGoogle ScholarPubMed
Rassaby, E. & Paykel, E. S. (1979). Factor patterns in depression - a replication study. Journal of Affective Disorders 1, 187–194.Google Scholar
Sheehan, D. V. (1984). Delineation of anxiety and phobic disorders responsive to monoamine oxidase inhibitors: implications for classification. Journal of Clinical Psychiatry 45, 7 (Sec. 2): 29–36.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1979). Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders 3rd ed.New York State Psychiatric Institute: New York.Google Scholar
Strauss, J. S., Gabriel, K. R., Kokes, R. F., Ritzier, B. A., Van Ord, A. & Tarana, E. (1979). Do psychiatric patients fit their diagnosis? Journal of Nervous Mental Disorders 167, 105–113.CrossRefGoogle Scholar
Swartz, M., Blazer, D., Woodbury, M., George, L. & Landerman, R. (1986). Somatization disorder in a US southern community: use of a new procedure for analysis of medical classifications. Psychological Medicine 16, 595–609.Google Scholar
van Valkenberg, C., Akiskal, H. S., Puzantian, V. & Rosenthal, T. (1984). Anxious depressions: clinical, family history and naturalistic outcome. Journal of Affective Diseases 6, 53–66.Google Scholar
Wilson, E. B. & Hilferty, M. M. (1931). The distribution of chisquare. Proceedings of the National Academy of Science USA 17, 684.Google Scholar
Winokur, G. R., Cadoret, R., Dorzab, J. & Baker, M. (1971). Depressive disease, a genetic study. Archives of General Psychiatry 24, 135–144.Google Scholar
Woodbury, M. A. & Clive, J. (1974). Clinical pure types as a fuzzy partition. Journal of Cybernetics 4 (3), 111–121.Google Scholar
Woodbury, M. A. & Manton, K. G. (1982). A new procedure for analysis of medical classification. Methods of Information in Medicine 21, 210–220.Google Scholar
Zadeh, L. (1965). Fuzzy sets. Information Control 8, 338–353Google Scholar