The Bearing of Treatment on the Classification of the Affective Disorders

¹ Senior Research Officer, Psychological Medicine Research Unit, University of Newcastle upon Tyne
² Professor of Psychological Medicine, Psychological Medicine Research Unit, University of Newcastle upon Tyne
³ Lecturer in Psychological Medicine, Psychological Medicine Research Unit, University of Newcastle upon Tyne

This study is based on a group of 154 hospital patients suffering from primary affective disorders. The aim of the study was to examine the nosological relationship between anxiety states and depressive illnesses from the standpoint of two aspects of treatment: therapeutic practice and treatment response.

The allocation of patients to one of the two diagnostic groups was made independently of the clinicians in charge of the management and treatment of the patients; the therapeutic response was assessed in terms of the clinico-social state of the patients both on discharge from hospital and six months later by two of the investigators who were unaware of the diagnosis made of the original illness.

Physical treatment was considered in terms of four main categories: electroconvulsive therapy, tricyclic antidepressants, monoamine oxidase inhibitors and sedatives or tranquillizers.

ECT and tricyclic antidepressants were prescribed significantly more frequently to patients with depressive illness, while sedatives and tranquillizers were given significantly more often to patients with anxiety states. Patients with anxiety states were also prescribed monoamine oxidase inhibitors more frequently, the difference almost reached the level of statistical significance.

The response to electronconvulsive therapy was significantly better in patients with depressive illnesses than in those with anxiety states, both on discharge from hospital and six months later. A similar difference was found when the response of the two diagnostic groups to tricyclic antidepressants was compared.

These findings provide some validation for the broad subdivision of affective disorders into anxiety states and depressive illness.

This article has been cited by other articles:

				D. S. Robinson, A. Nies, C. L. Ravaris, and K. R. Lamborn The Monoamine Oxidase Inhibitor, Phenelzine, in the Treatment of Depressive-Anxiety States: A Controlled Clinical Trial Arch Gen Psychiatry, September 1, 1973; 29(3): 407 - 413. [Abstract] [PDF]

				L. R. Derogatis, R. S. Lipman, L. Covi, and K. Rickels Factorial Invariance of Symptom Dimensions in Anxious and Depressive Neuroses Arch Gen Psychiatry, November 1, 1972; 27(5): 659 - 665. [Abstract] [PDF]