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Depressive Illness and Morbid Distress

Onset and Development Data Examined against Five-Year Outcome

Published online by Cambridge University Press:  29 January 2018

J. R. M. Copeland
J. R. M. Copeland*
Affiliation:
Institute of Psychiatry, London and University Department of Psychiatry, Liverpool, Royal Liverpool Hospital, P.O. Box 147, Liverpool L69 3BX
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Summary

A cluster analysis was done on items concerned with the onset and development (including life events) of depressive illness derived from standardised interviews on 70 in-patients with that diagnosis. The resulting groups were compared for symptoms derived from the Present State Examination (PSE) and outcome, five years later. New Groupings were sought, based on onset and development data, to test their predictive power, and to observe how closely they replicated existing binary classifications and whether or not suggestions emerged for narrowing the concept of depressive illness. The groups were clinically recognisable, and measures of five-year outcome differed significantly between the groups. They have been designated as forms of ‘Somatic depression’, type I ‘Slow onset—depression of middle age’; type II ‘Rapid onset—depression of middle age’; type III ‘Slow onset — depression of younger age’; type IV ‘Rapid onset — depression of younger age, and morbid distress. It is suggested that no simple binary classification is likely to prove as satisfactory for depression as a multi-axial method; the concept of ‘morbid distress' is advanced as a way of narrowing the over-extended rubric of depressive illness.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 146 , Issue 3 , March 1985 , pp. 297 - 307
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders. Third edition, Washington D.C.: A.P.A. Google Scholar
Andreasen, N. C., Grove, W. M. & Maurer, R. (1980) Cluster analysis and the classification of depression. British Journal of Psychiatry, 137, 256–265.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. London: Tavistock Publications.Google ScholarPubMed
Brown, G. W. & Harris, T., Sklair, F., Harris, T. & Birley, J. L. T. (1973) Life events and psychiatric disorders: 1. Some methodological issues. Psychological Medicine, 3, 74–87.CrossRefGoogle ScholarPubMed
Copeland, J. R. M. (1975) The onset and development of depressive illness and its relationship to diagnosis. M.D. Thesis, University of Cambridge.Google Scholar
Copeland, J. R. M. (1980) Lebensverändernde Ereignisse und die Diagnose Depression. In Sozialer stress und psychische Erkrankung (Editor: Katschnig, H.). München-Wien-Baltimore: Urbane Schwarzenberg, 238–249.Google Scholar
Copeland, J. R. M. (1983) Psychotic and neurotic depression: discriminant function analysis and five-year outcome. Psychological Medicine, 13, 373–383.Google Scholar
Copeland, J. R. M. (1984) Reactive and endogenous depressive illness: Five-year outcome. Journal of Affective Disorders, 6, 153–162.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Smith, A. & Dewey, M. E. (1985) Prevalence of mental illness amongst the elderly living in London. Submitted for publication.Google Scholar
Gurland, B., Copeland, J. R. M., Kuriansky, J., Kelleher, M. J., Sharpe, L. & Dean, L. L. (1983) The Mind and Mood of Aging, Mental Health Problems of the Community Elderly in New York and London, New York: Haworth Press.Google Scholar
Fleiss, J. L. (1972) Classification of the depressive disorders by numerical typology. Journal of Psychiatric Research, 9, 141–153.CrossRefGoogle ScholarPubMed
Marriott, F. H. C. (1971) Practical problems in a method of cluster analysis. Biometrics, 27, 501–514.CrossRefGoogle Scholar
McRae, D. J. (1971) MICKA: A Fortran IV Iterative K-means cluster analysis program. Abstract, Behavioural Science, 16, 423–424.Google Scholar
Paykel, E. S. (1971) Classification of depressed patients: a cluster analysis derived grouping. British Journal of Psychiatry, 118, 275–288.Google Scholar
Raskin, A. & Crook, T. H. (1976) The endogenous-neurotic distinction as a predictor of response to anti-depressant drugs. Psychological Medicine, 6, 59–70.Google Scholar
Strauss, J. S., Bartko, J. J. & Carpenter, W. T. (1973) The use of clustering techniques for the classification of psychiatric patients. British Journal of Psychiatry, 122, 531–540.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Descriptions and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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