Life events and the research diagnostic criteria endogenous subtype. A confirmation of the distinction using the Bedford College methods.

BACKGROUND Despite the advances in biological and psychosocial assessment methods, reliable distinction between depressed patients with endogenous presentations or melancholic symptom features and those with nonendogenous presentations has remained elusive. METHODS Ninety patients with histories of frequent unipolar episodes classified as endogenous or nonendogenous by the Research Diagnostic Criteria were interviewed with the Bedford College Life Events and Difficulties Schedule regarding the 6 months before onset of their most recent episode of depression. RESULTS Patients meeting the Research Diagnostic Criteria for definite endogenous subtype differed significantly from patients with nonendogenous features in terms of the proportion experiencing severe life stress in the 6 months before onset of their depressive episode (P < = .04). Furthermore, survival analysis revealed a closer temporal association between severe event and depression onset among patients with nonendogenous features (P < .02). CONCLUSION Even among patients with a history of multiple recurrences of depression, psychological stress plays an important role in the timing of onset of episodes characterized by nonendogenous features.

[1]  G. Brown,et al.  Life events and endogenous depression. A puzzle reexamined. , 1994, Archives of general psychiatry.

[2]  D. Kupfer,et al.  Maintenance treatment and psychobiologic correlates of endogenous subtypes. , 1992, Journal of affective disorders.

[3]  D. Kupfer,et al.  Five-year outcome for maintenance therapies in recurrent depression. , 1990, Archives of general psychiatry.

[4]  M. Free,et al.  Biological and psychological processes in the treatment and maintenance of depression: an investigation of four models , 1989 .

[5]  D. Kupfer,et al.  Social zeitgebers and biological rhythms. A unified approach to understanding the etiology of depression. , 1988, Archives of general psychiatry.

[6]  D. Black,et al.  Depressions secondary to other psychiatric disorders and medical illnesses. , 1988, The American journal of psychiatry.

[7]  N C Andreasen,et al.  Isolation and characterization of a nuclear depressive syndrome , 1987, Psychological Medicine.

[8]  T. Brugha,et al.  Categories of Depression: Reported Life Events in a Controlled Design , 1985, British Journal of Psychiatry.

[9]  R. Dolan,et al.  Life Events, Depression and Hypothalamic–Pituitary–Adrenal Axis Function , 1985, British Journal of Psychiatry.

[10]  D. G. Cornell,et al.  Stressful Life Events Associated with Endogenous Depression , 1985, The Journal of nervous and mental disease.

[11]  E. Paykel,et al.  Life stress and symptom pattern in out-patient depression , 1984, Psychological Medicine.

[12]  G. Klerman,et al.  Interpersonal psychotherapy of depression , 1984 .

[13]  J. Copeland.  Reactive and endogenous depressive illness and five-year outcome. , 1984, Journal of affective disorders.

[14]  J. Kocsis,et al.  Psychotic vs. nonpsychotic depression: comparison of treatment response. , 1982, The Journal of nervous and mental disease.

[15]  T. Harris,et al.  Social Origins of Depression: A Study of Psychiatric Disorder in Women , 1979 .

[16]  J. Endicott,et al.  A diagnostic interview: the schedule for affective disorders and schizophrenia. , 1978, Archives of general psychiatry.

[17]  J. Fleiss,et al.  The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. , 1976, Archives of general psychiatry.

[18]  D. Klein.  Endogenomorphic depression. A conceptual and terminological revision. , 1974, Archives of general psychiatry.

[19]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.