Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-17T16:59:30.031Z Has data issue: false hasContentIssue false

Neurotic Depression: Delineation of Symptom Profiles and Their Relation to Outcome

Published online by Cambridge University Press:  02 January 2018

Abstract

Ninety-one subjects diagnosed clinically as having a ‘neurotic depression’ were interviewed and then re-assessed at 6 weeks and 20 weeks. Four symptom profiles of clinical features were derived: ‘negative cognition’, ‘lack of drive’, ‘anxiety’, and ‘arousal’, the last being independent of the other three dimensions and of the severity of depression. Symptom profile scores were then examined against antecedent risk variables and outcome. Links between profile scores and personality variables suggest that personality may colour the clinical presentation of neurotic/reactive depressions, and challenge the assumption that a typology of these depressive disorders based on clinical features is achievable. The break-up of an intimate relationship in the preceding 12 months was a strong predictor of a good outcome. Further analyses suggested, firstly, that there was a distinct subgroup delineated by this life event, with features weighted to the ‘arousal’ symptom profile, including many symptoms often associated with diagnosis of ‘endogenous depression’; and, secondly, that this life event and a good outcome were directly linked, being uninfluenced by personality or other mediating variables.

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). (DSM-III). Washington, DC: American Psychiatric Association.Google Scholar
Bebbington, P., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981) Epidemiology of mental disorders in Camberwell. Psychological Medicine, 11, 561579.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.CrossRefGoogle ScholarPubMed
Ni Bhrolcháin, M. (1979) Psychotic and neurotic depression: 1. Some points of method. British Journal of Psychiatry, 195, 946950.Google Scholar
Bibring, E. (1953) The mechanism of depression. In Affective Disorders (ed. P. Greenacre). New York: International University Press.Google Scholar
Blashfield, R. K. & Morey, L. C. (1979) The classification of depression through cluster analysis. Comprehensive Psychiatry, 20, 516527.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women. London: Tavistock Publications.Google Scholar
Clayton, P., Desmaris, L. & Winokur, G. (1968) A study of normal bereavement. American Journal of Psychiatry, 125, 168178.CrossRefGoogle ScholarPubMed
Cooke, D. J. (1980) The structure of depression found in the general population. Psychological Medicine, 10, 455463.CrossRefGoogle ScholarPubMed
Everitt, B. S., Gourlay, A. J. & Kendell, R. E. (1971) An attempt at validation of traditional psychiatric syndromes by cluster analysis. British Journal of Psychiatry, 119, 399412.CrossRefGoogle ScholarPubMed
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory. London: University of London Press.Google Scholar
Freud, S. (1917) Mourning and melancholia. In The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 14 (ed. J. Strachey). London: Hogarth Press.Google Scholar
Grinker, R. R., Miller, J., Sabshin, M., Nunn, R. & Nunnally, J. C. (1961) The Phenomena of Depression. New York: Harper and Row.Google Scholar
Henderson, S., Byrne, D. G. & Duncan-Jones, P. (1981) Neurosis and the Social Environment. Sydney: Academic Press.Google Scholar
Hrycenko, I. & Minton, M. L. (1974) Internal-external control, power position and satisfaction in task orientated groups. Journal of Personality and Social Psychology, 30, 871878.CrossRefGoogle ScholarPubMed
Kendell, R. E. (1976) The classification of depressions: a review of contemporary confusion. British Journal of Psychiatry, 129, 1528.CrossRefGoogle ScholarPubMed
Kiloh, L. G., Andrews, G., Neilson, M. & Bianchi, G. N. (1972) The relationship of the syndromes called endogenous and neurotic depression. British Journal of Psychiatry, 121, 183196.CrossRefGoogle ScholarPubMed
Kiloh, L. G., Andrews, G., Neilson, M., Bianchi, G. N. & Garside, R. F. (1977) Depression: a multivariate study of Sir Aubrey Lewis' data on melancholia. Australian and New Zealand Journal of Psychiatry, 11, 149156.CrossRefGoogle Scholar
Matussek, P., Soldner, M. L. & Nagel, D. (1982) Neurotic depression: results of cluster analyses. Journal of Nervous and Mental Disease, 170, 588597.CrossRefGoogle ScholarPubMed
Overall, J. E., Hollister, L. E., Johnson, M. & Pennington, J. (1966) Nosology of depression and differential response to drugs. Journal of the American Medical Association, 195, 946950.CrossRefGoogle ScholarPubMed
Parker, G. (1983) Parental Overprotection: A Risk Factor in Psychosocial Development. New York: Grune and Stratton.Google Scholar
Parker, G., Tupling, H. & Brown, L. B. (1979) A parental bonding instrument. British Journal of Medical Psychology, 52, 110.CrossRefGoogle Scholar
Parker, G., Tupling, H., Brown, L. B. & Blignault, I. (1983) A comparative study of neurotic depression in symptomatic volunteers and psychiatric patients. Australian and New Zealand Journal of Psychiatry, 17, 7481.CrossRefGoogle ScholarPubMed
Parker, G., Tupling, H., Brown, L. B. & Blignault, I. (1984) Psychological predictors of improvement in subjects with untreated depressive disorders. Journal of Affective Disorders, 8, 7381.CrossRefGoogle Scholar
Parker, G., Tupling, H., Brown, L. B., Blignault, I., Tennant, C. & Blignault, I. (1985) Predicting improvement in patients with non-endogenous depression. British Journal of Psychiatry, 146, 287293.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1971) Classification of depressed patients: a cluster analysis derived grouping. British Journal of Psychiatry, 118, 275288.CrossRefGoogle ScholarPubMed
Paykel, E. S., Myers, J. K., Dienelt, M. N., Klerman, G. L., Lindenthal, J. J. & Pepper, M. P. (1969) Life events and depression. Archives of General Psychiatry, 21, 753760.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965) Society and the Adolescent Self-Image. Princeton: Princeton University Press.CrossRefGoogle Scholar
Roth, M., Garside, R. F., Gurney, C. & Kerr, T. A. (1979) Psychotic and neurotic depression: a reply on method. British Journal of Psychiatry, 135, 9496.CrossRefGoogle ScholarPubMed
Weissman, A. N. (1980) Assessing depressogenic attitudes: a validation study. Paper presented at the 51st annual Meeting of the Eastern Psychological Association, Hartford, Connecticut.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Cooper, J. E., Sartorius, N. & Sturt, E. (1978) The PSE-ID-CA TEGO System Supplementary Manual. London. MRC Social Psychiatry Unit.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. Geneva: WHO.Google Scholar
Zung, W. W. K. (1964) A self-rating depression scale. Archives of General Psychiatry, 12, 6370.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.