Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T20:40:43.669Z Has data issue: false hasContentIssue false
  • English
  • Français

Major Depression, Dysthymia and Depressive Personality Disorder

Published online by Cambridge University Press:  06 August 2018

Robert M. A. Hirschfeld
Robert M. A. Hirschfeld*
Affiliation:
University of Texas, Graves Building (Room 1200), 1014 Texas Avenue, Galveston, TX 77555, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

The separation of persistent depression into meaningful and useful subcategories, including major depression, dysthymia, recurrent brief depression, and depressive personality disorder, is the subject of much debate. Depressions can be grouped on the basis of their type and severity of symptoms, aetiology, clinical course, or their association with other psychiatric illnesses. Several investigators have conducted epidemiologic and family studies to evaluate the prevalence of depressive disorders, their diagnostic stability over time, and the amount of overlap among the disorders. Although progress has been made toward a better understanding of the different disorders, insufficient evidence exists to support the hypothesis that these disorders are separate and distinct from one another. However, preliminary data suggest that depressive personality disorder is separate from the other disorders. Additionally, several questions have been raised, particularly the extent to which differentiation between the depressive disorders, specifically major depression and dysthymia, has an impact on treatment decisions.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue S26: Depression: Challenge for the '90s , December 1994 , pp. 23 - 30
Copyright
Copyright © 1994 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

Akiskal, H. S. (1983) Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. American Journal of Psychiatry, 140, 11–20.Google ScholarPubMed
Akiskal, H. S. (1989) Validating affective personality types. In The Validity of Psychiatric Diagnosis (ed. Robins, L.), pp. 217–227. New York: Raven Press.Google Scholar
Akiskal, H. S., Rosenthal, T. L., Haykal, R. F., et al (1980) Characterological depressions. Archives of General Psychiatry, 37, 777–783.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Angst, J. (1992) Epidemiology of depression. Psychopharmacology, 106, S71–S74.CrossRefGoogle ScholarPubMed
Angst, J., Merikangas, K., Schneidegger, P., et al (1990) Recurrent brief depression: a new subtype of affective disorder. Journal of Affective Disorders, 19, 87–98.Google Scholar
Angst, J., & Wicki, W. (1991) Is dysthymia a separate form of depression? Results from the Zurich Cohort study. European Archives of Psychiatry and Clinical Neuroscience, 240, 349–354.Google Scholar
Davidson, J. R., Giller, E. L., Zisook, S., et al (1988) An efficacy study of isocarboxazid and placebo in depression, and its relationship to depressive nosology. Archives of General Psychiatry, 45, 120–127.Google Scholar
Gonzales, L. R., Lewinsohn, P. M. & Clarke, G. N. (1985) Longitudinal follow-up of unipolar depressives: an investigation of predictors of relapse. Journal of Consulting and Clinical Psychology, 53, 461–469.Google Scholar
Guy, W., Ban, T. A. & Schaffer, J. D. (1983) Differential treatment responsiveness among mildly depressed patients. In Treatment of Depression: Old Controversies and New Approaches (eds. Clayton, P. J. & Barrett, J. E.), pp. 229–236. New York: Raven Press.Google Scholar
Harrison, W., Rabkin, J., Stewart, J. W., et al (1986) Phenelzine for chronic depression: a study of continuation treatment. Journal of Clinical Psychiatry, 47, 346–349.Google Scholar
Hirschfeld, R. M. A. & Shea, M. T. (1992) Personality and depression. In Handbook of Affective Disorders (2nd edn) (ed. Paykel, E. S.). Edinburgh: Churchill Livingstone.Google Scholar
Howland, R. H. & Thase, M. E. (1991) Biological studies of dysthymia. Biological Psychiatry, 30, 283–304.Google Scholar
Keller, M. B. (1994) Depression: a long-term illness. British Journal of Psychiatry, 165 (suppl. 26), 9–15.Google Scholar
Keller, M. B. & Shapiro, R. W. (1982) “Double depression”: superimposition of acute depressive episodes on chronic depressive disorders. American Journal of Psychiatry, 139, 438–442.Google Scholar
Keller, M. B., Lavori, P. W., Endicott, J., et al (1983) “Double depression”: two-year follow-up. American Journal of Psychiatry, 140, 689–694.Google Scholar
Keller, M. B., Hirschfeld, R. M. A., Klein, D. N., et al (submitted) DSM–IV mood disorders Field Trial investigation results. American Journal of Psychiatry.Google Scholar
Klein, D. N., Taylor, E. B., Dickstein, S., et al (1988) The early-late onset distinction in DSM–III–R dysthymia. Journal of Affective Disorders, 14, 25–33.Google Scholar
Klein, D. N. & Miller, G. A. (1993) Depressive personality in a nonclinical sample. American Journal of Psychiatry, 150, 1718–1724.Google Scholar
Kocsis, J. H., Frances, A. J., Voss, C., et al (1988) Imipramine treatment for chronic depression. Archives of General Psychiatry, 45, 253–257.CrossRefGoogle ScholarPubMed
Kraepelin, E. (1921) Manic Depressive Insanity and Paranoia (ed. Robertson, G. M., trans. Barclay, R. M.). Edinburgh: E. & S. Livingstone.Google Scholar
McCullough, J. P., Braith, J. A., Chapman, R. C., et al (1990) Comparison of early and late onset dysthymia. Journal of Nervous and Mental Disease, 78, 577–581.Google Scholar
Paskind, H. A. (1929) Brief attacks of manic–depressive depressions. Archives of Neurology, 22, 123–134.Google Scholar
Paykel, E. S., Freeling, P., Hollyman, J. A., et al (1988) Predictors of therapeutic benefit from amitriptyline in mild depression: a general practice placebo-controlled trial. Journal of Affective Disorders, 14, 83–95.Google Scholar
Phillips, K. A., Gunderson, J. G., Hirschfeld, R. M. A., et al (1990) A review of the depressive personality. American Journal of Psychiatry, 147, 830–837.Google Scholar
Phillips, K. A., Gunderson, J. G., Triebwasser, J., et al (1992) An empirical study of depressive personality disorder. Presented at the American Psychiatric Association 145th Annual Meeting, May 1992 Abstracts p. 197.Google Scholar
Phillips, K. A., Hirschfeld, R. M. A., Shea, M. T., et al (1993) Depressive personality disorder: perspectives for DSM–IV. Journal of Personality Disorders, 1, 30–42.Google Scholar
Schneider, K. (1958) Psychopathic Personalities. Springfield, Illinois: Charles C. Thomas.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Stewart, J. W., Quitkin, F. M., Liebowitz, M. R., et al (1983) Efficacy of desipramine in depressed outpatients. Response according to research diagnosis criteria diagnoses and severity of illness. Archives of General Psychiatry, 40, 202–207.Google Scholar
Stewart, J. W., McGrath, P. J., Liebowitz, M. R., et al (1985) Treatment outcome validation of DSM–III depressive subtypes. Clinical usefulness in outpatients with mild to moderate depression. Archives of General Psychiatry, 42, 1148–1153.Google Scholar
Torgersen, S. (1986) Genetic factors in moderately severe and mild affective disorders. Archives of General Psychiatry, 43, 222–226.CrossRefGoogle ScholarPubMed
Tyrer, P., Seivewright, N., Murphy, S., et al (1988) The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. Lancet, 2, 235–240.Google Scholar
Vallejo, J., Gasto, C., Catalan, R., et al (1987) Double-blind study of imipramine versus phenelzine in melancholias and dysthymic disorders. British Journal of Psychiatry, 151, 639–642.Google Scholar
Ware, J. E., Sherbourne, C. A., Davies, A. R., et al (1988) A Short-Form General Health Survey. Santa Monica: The Rand Corporation.Google Scholar
Waring, E. M., Chamberlaine, C. H., McCrank, E. W., et al (1988) Dysthymia: a randomized study of cognitive marital therapy and antidepressants. Canadian Journal of Psychiatry, 33, 96–99.Google Scholar
Weissman, M. M., Bruce, M. L., Leaf, P. J., et al (1991) Affective disorders. In Psychiatric Disorders in America: The Epidemiologic Catchment Area Study, pp. 53–80. New York: Free Press.Google Scholar
Wittchen, H. U., Essau, C. A., Von Zerssen, D., et al (1992) Lifetime and six-month prevalence of mental disorders in the Munich follow-up study. European Archives of Psychiatry and Clinical Neuroscience, 241, 247–258.Google Scholar
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.