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Isolation and characterization of a nuclear depressive syndrome

Published online by Cambridge University Press:  09 July 2009

W. M. Grove ,
N. C. Andreasen ,
M. Young ,
J. Endicott ,
M. B. Keller ,
R. M. A. Hirschfeld  and
T. Reich
W. M. Grove*
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
N. C. Andreasen
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
M. Young
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
J. Endicott
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
M. B. Keller
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
R. M. A. Hirschfeld
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
T. Reich
Affiliation:
Department of Psychiatry, University of Minnesota, University of Iowa, Rush-Presbyterian-St Luke's Medical Center, Chicago, Department of Research and Training, New YorkState Psychiatric Institute, Lindemann Mental Health Center, Harvard University, BostonCenter for Affective Disorders, National Institute of Mental Health, Rockville and the Department of Psychiatry, Jewish Hospital, St Louis, USA
*
1Address for correspondence: Dr W. M. Grove, Department of Psychiatry, University of Minnesota, Box 393 Mayo, Minneapolis MN55455. USA
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Synopsis

We investigated the nosology of endogenous depression by numerical taxonomy. Five hundred and sixty-nine patients diagnosed as having unipolar major depressive disorder in the NIMH Clinical Research Branch Program on the Psychobiology of Depression – Clnical were studied. Thirty-six symptoms which might distinguish endogenous from non-endogenous depressions were chosen from the literature. Patients' symptom profiles assessed by structured interview were grouped by two methods: a K-means improvement of Ward's method of cluster analysis, and a latent class algorithm. The methods produced very similar groups and several internal validity criteria suggested that the groups were not spurious. Cluster 1, ‘nuclear depression,’ included a nucleus of patients common to multiple definitions of endogenous depression. The non-nuclear group scored as less neurotic than the nuclear group on personality tests administered during the index episode. The groups do not differ in frequency, number or severity of reported life events prior to onset of the index episode. The nuclear group shows a poor prognosis on two-year prospective follow-up, greater disturbance on personality inventories, and increased heritability of depression in siblings.

Type
Research Article
Information
Psychological Medicine , Volume 17 , Issue 2 , May 1987 , pp. 471 - 484
Copyright
Copyright © Cambridge University Press 1987

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References

Andreasen, N. C., Endicott, J., Spitzer, R. L. & Winokur, G. (1977). The family history method using diagnostic criteria: reliability and validity. Archives of General Psychiatry 34, 1229–1235.Google Scholar
Andreasen, N. C. & Grove, W. M. (1982). The classification of depression: traditional versus mathematical approaches. American Journal of Psychiatry 139, 45–52.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.Google Scholar
Andreasen, N. C., Grove, W. M., Shapiro, R. W., Keller, M. B., Hirschfeld, R. M. A. & McDonald-Scott, P. (1981). Reliability of lifetime diagnosis: a multicenter collaborative perspective. Archives of General Psychiatry 38, 400–405.CrossRefGoogle ScholarPubMed
Andreasen, N. C., McDonald-Scott, P., Grove, W. M., Keller, M. B., Shapiro, R. W. & Hirschfeld, R. M. A. (1982). Assessment of reliability in multicenter collaborative research with a videotape approach. American Journal of Psychiatry 139, 876–882.Google ScholarPubMed
Andreasen, N. C., Rice, J., Endicott, J., Reich, T. & Coryell, W. (1986 a). The family history approach to diagnosis: how accurate and useful is it? Archives of General Psychiatry 43, 421–429.Google Scholar
Andreasen, N. D., Scheftner, W., Reich, T., Hirschfeld, R. M. A., Endicott, J. & Keller, M. B. (1986 b). The validation of the concept of endogenous depression: a family study approach. Archives of General Psychiatry 43, 246–251.Google Scholar
Beale, E. M. L. (1969). Cluster Analysis. Scientific Control Systems: London.Google Scholar
Benjaminsen, S. (1981). Primary non-endogenous depression and features attributed to reactive depression. Journal of Affective Disorders 3, 245–259.Google Scholar
Blashfield, R. K. & Morey, L. C. (1979). The classification of depression through cluster analysis. Comprehensive Psychiatry 20, 516–527.CrossRefGoogle ScholarPubMed
Block, J. (1965). The Challenge of Response Sets. Appleton–Century–Crofts: New York.Google Scholar
Brown, G. W., Ni Bhrolchain, M. & Harris, T. O. (1979). Psychotic and neurotic depression. 3. Aetiological and background factors. Journal of Affective Disorders 1, 195–211.CrossRefGoogle ScholarPubMed
Brugha, T. S. & Conroy, R. (1985). Categories of depression: Reported life events in a controlled design. British Journal of Psychiatry 147,641–646.Google Scholar
Byrne, D. G. (1978). A note on cluster analysis and depression: disparities in results produced by the application of different clustering methods. Australian and New Zealand Journal of Psychiatry 12, 99–102.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965). The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry 111, 659–674.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
Dohrenwend, B. S., Krasnoff, L., Askenasy, A. R. & Dohrenwend, B. P. (1978). Exemplification of a method for scaling life events: the PERI Life Events Scale. Journal of Health and Social Behavior 19, 205–229.CrossRefGoogle ScholarPubMed
Duda, R. O. & Hart, P. E. (1973). Pattern Classification and Scene Analysis. Wiley: New York.Google Scholar
Edelbrock, C. (1979). Comparing the accuracy of hierarchial clustering alogrithms: the problem of classifying everybody. Multivariate Behavioral Research 14, 367–384.Google Scholar
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837–844.Google Scholar
Everitt, B. S. (1981). Biomodality and the nature of depression. British Journal of Psychiatry. 138, 336–339.Google Scholar
Eysenck, H. J. (1960). The Structure of Human Personality. Methuen: London.Google Scholar
Eysenck, H. J. (1970). The classification of depressive illness. British Journal of Psychiatry 117, 241–250.CrossRefGoogle Scholar
Forrest, A. D., Fraser, R. H. & Priest, R. G. (1965). Environmental factors in depressive illness. British Journal of Psychiatry 111, 243–253.CrossRefGoogle ScholarPubMed
Gillespie, R. D. (1929). The clinical differentiation of types of depression. Guy's Hospital Report Services IV, 9, 306–344.Google Scholar
Golden, R. R. (1982). A taxometric model for the detection of a conjectured latent taxon. Multivariate Behavioural Research 17, 389–416.CrossRefGoogle ScholarPubMed
Goldstein, M. & Dillon, W. R. (1978). Discrete Discriminant Analysis. Wiley: New York.Google Scholar
Grove, W. M. (1986). Validity of taxometric inferences from cluster analysis. (Submitted to Multivariate Behavioural Research.)Google Scholar
Guilford, J. P., Zimmerman, W. S. & Guildford, J. P. (1976).The Guildord–Zimmerman Temperament Survey Handbook. Education and Industrial Testing Service: San Diego.Google Scholar
Hamilton, M. & White, J. M. (1959). Clinical syndromes in depressive states. Journal of Mental Science 105, 985–998.Google Scholar
Hirschfeld, R. M. A. (1981). Situational depression Validity of the concept. British Journal of Psychiatry 139, 297–305.CrossRefGoogle ScholarPubMed
Hirschfeld, R. M. A., Klerman, G. L., Clayton, P. J. & Keller, M. B. (1983 a). Personality and depression: empirical findings. Archives of General Psychiatry 40, 993–998.CrossRefGoogle ScholarPubMed
Hirschfeld, R. M. A., Klerman, G. L., Clayton, P. J., Keller, M. B. & Andreasen, N. C. (1983 b). Personality and gender-related differences in depression. Journal of Affective Disorders 7, 211–221.Google Scholar
Hirschfeld, R. M. A., Klerman, G. L., Clayton, P. J., Keller, M. B., McDonald-Scott, P. & Larkin, B. H. (1983 c). Assessing personality: effects of the depressive state on trait measurement. American Journal of Psychiatry 140, 695–699.Google Scholar
Hirschfeld, R. M. A., Klerman, G. L., Gough, H. G., Barrett, J., Korchin, S. J. & Chodoff, P. (1977). A measure of interpersonal dependency. Journal of Personality Assessment 41 610–618.Google Scholar
Holmes, T. H. & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research 11, 213–218.CrossRefGoogle ScholarPubMed
Kalbfleisch, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data. Wiley: New York.Google Scholar
Katz, M. M. & Hirschfeld, R. M. A. (1978). Phenomenology and classification of depression. In Psychopharmacology: A Generation of Progress. (ed. Lipton, M. A., DiMascio, A., & Killan, K. F.,) pp. 1185–1195. Raven Press: New York.Google Scholar
Katz, M. M. & Klerman, G. L. (1979). Introduction-Overview of the clinical studies program. American Journal of Psychiatry 136, 49–51.Google Scholar
Kay, D. W. K., Garside, R. F., Roy, J. R. & Beamish, P. (1965). ‘Endogenous’ and ‘neurotic’ syndromes of depression: a 5–7 year follow-up of 104 cases. British Journal of Psychiatry 115, 389–399.Google Scholar
Keller, M. B., Lavori, P. W., Andreasen, N. C., Grove, W. M., Shapiro, R. W., Scheftner, W. A. & McDonald-Scott, P. (1981). Test–retest reliability of assessing psychiatrically ill patients in a multicenter design.Journal of Psychiatric Research 16, 213–227.Google Scholar
Keller, M. B., Lavori, P., Friedman, B., Nielson, E., Endicott, J., McDonald-Scott, P. & Andreasen, N. C. (1986). The LIFE: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry. (in press).Google Scholar
Kendell, R. E. (1969). The continuum model of depressive illness. Proceedings of the Royal Society of Medicine 62, 335–339.CrossRefGoogle ScholarPubMed
Lange, J. (1926). Über melancholie. Zentralblatt für die gesamte Neurologie und Psychiatrie 101, 293–319.Google Scholar
Lazare, A., Klerman, G. L. & Armor, D. J. (1966). Oral, obsessive, and hysterical personality patterns: an investigation of psychoanalytic concepts by means of factor analysis. Archives of General Psychiatry 14, 624–630.CrossRefGoogle ScholarPubMed
Lazarsfeld, P. F. & Henry, N. W. (1968). Latent Structure Analysis. Houghton Mifflin. Boston.Google Scholar
Leff, M. J., Roatch, J. F. & Bunney, W. E. (1970). Environmental factors preceedings the onset of severe depressions. Psychiatry 33, 293–311.CrossRefGoogle Scholar
Lewis, A. (1938). States of depression: their clinical and aetiological differentiation. British Medical Journal ii, 875–878.CrossRefGoogle Scholar
Mapother, E. (1926). Discussion on manic-depressive psychosis. British Medical Journal ii, 872–876.Google Scholar
Matussek, P. & Feil, W. B. (1983). Personality attributes of depressive patients: results of group comparisons. Archives of General Psychiatry 40, 783–790.Google Scholar
Matussek, P. & Neuner, R. (1981). Life events preceeding endogenous and neurotic depressions. Acta Psychiatrica Scandinavica 64, 340–350.Google Scholar
Milligan, G. W. (1981). A review of Monte Carlo tests of cluster analysis. Multivariate Behavioural Research 16, 379–407.Google Scholar
Milligan, G. W. & Cooper, M. C. (1983). An examination of procedures for determining the number of clusters in a data set. Ohio State University College of Administrative Science Working Paper Series WPS 83–51: Columbus, Ohio.Google Scholar
Murphy, E. A. (1964). One cause? Many causes? The argument from a bimodal distribution. Journal of Chronic Diseases 17, 301–324.CrossRefGoogle ScholarPubMed
Paykel, E. S. & Henderson, A. J. (1977). Application of cluster analysis in the classification of depression: a replication study. Neuropsychobiology 3, 111–119.CrossRefGoogle ScholarPubMed
Paykel, E. S., Prusoff, B. A. & Uhlenhuth, E. M. (1971). Scaling of life events. Archives of General Psychiatry 25, 340–347.CrossRefGoogle ScholarPubMed
Prusoff, B. A. & Paykel, E. S. (1977). Typological prediction of response to amitriptyline: a replication study. International Pharmacopsychiatry 12, 153–159.Google Scholar
Rao, V. A. R., & Coppen, A. (1979). Classification of depression and response to amitriptyline therapy. Psychological Medicine 9, 321–325.CrossRefGoogle ScholarPubMed
Rosenthal, S. H. & Gudeman, J. E. (1967). The endogenous depressive pattern: an empirical investigation. Archives of General Psychiatry 16, 241–249.Google Scholar
SAS Institute, Inc. (1982). SAS User's Guide: Statistics, 1982 edition. SAS Institute, Inc: Cary, North Carolina.Google Scholar
Searle, S. R. (1971). Linear models. Wiley: New York.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.CrossRefGoogle ScholarPubMed
Tennant, C. & Andrews, G. (1976). A scale to measure the Stress of life events. Australia and New Zealand Journal of Psychiatry 10, 27–32.CrossRefGoogle ScholarPubMed
Thomson, K. C. & Hendrie, H. C. (1972). Environmental stress in primary depressive illness. Archives of General Psychiatry 26, 130–132.Google Scholar
Wishart, D. (1982). CLUSTAN User Manaul, 3rd ed.Programme Library Unit, Edinburgh University: Edinburgh.Google Scholar
Young, M. A., Scheftner, W. A., Klerman, G. L., Andreasen, N. C. & Hirschfeld, R. M. A. (1986). The endogenous Subtype of depression: a study of its internal construct validity. British Journal of Psychiatry 148, 257–267.Google Scholar