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Heterogeneity of Depression

Classification of Depressive Subtypes by Longitudinal Course

Published online by Cambridge University Press:  02 January 2018

Kathleen Ries Merikangas ,
Werner Wicki  and
Jules Angst
Kathleen Ries Merikangas*
Affiliation:
Yale University School of Medicine, Departments of Psychiatry and Epidemiology, and Genetic Epidemiology Research Unit, 40 Temple Street, Lower Level, New Haven, Connecticut 06510-3223
Werner Wicki
Affiliation:
Research Department, Psychiatric University Hospital, PO Box 68, 8029 Zurich, Switzerland (now at University of Basel, Switzerland)
Jules Angst
Affiliation:
Research Department, Psychiatric University Hospital, 8029 Zurich, Switzerland
*
∗Correspondence
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Abstract

This paper describes the application of prospective longitudinal data from an epidemiological sample of young adults to define subtypes of major depression. Depression was classified on a spectrum from subthreshold manifestation of symptoms and duration at one end, to cases with recurrent episodes of depression meeting duration criteria for major depressive episodes at the other. There was a direct relationship between the severity of depression over the longitudinal course and both duration and recurrence of depressive episodes. The subgroup of depression with recurrence of both brief and longer duration episodes could be discriminated on most of the indicators of validity including symptoms, impairment, family history, and suicide attempts. In light of the young age of this cohort, the strong history of suicide attempts and other complications of depression among the subjects with recurrent depression was striking. These findings underscore the importance of employing course as a classification criterion of depression, and the inclusion of subthreshold episodes of depression in the characterisation of course.

Type
Peer Review
Information
The British Journal of Psychiatry , Volume 164 , Issue 3 , March 1994 , pp. 342 - 348
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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