Clinical subtypes of unipolar depression: Part I. A validation of the vital and nonvital clusters.
Cluster analyses were carried out on a sample of 100 depressed females. The study was based on the 14 items relevant to depressive phenomenology of the Structured Clinical Interview for DSM-III-R (SCID). Our findings support the existence of two classes, i.e., a vital (melancholic) vs. a nonvital cluster. The vital cluster is characterized by the following symptoms: a distinct quality of depressed mood, nonreactivity, early morning awakening, anorexia-weight loss, and cognitive and psychomotor disturbances. Patients belonging to the vital cluster exhibit disorders in the hypothalamic-pituitary-adrenal and thyroid axes and a markedly decreased availability of L-tryptophan to the brain. The vital depressives score significantly higher on the Hamilton Rating Scale for Depression as compared to those suffering from nonvital depression. The cluster-analytically derived class of vital depression and the DSM-III subtype of melancholia tend to be quite similar. Our findings support the isolation and the descriptive validity of a vital (melancholic) depressive syndrome.
Maes
M
M
Dept. of Biological Psychiatry, Clinical Psychobiology, University Hospital of Antwerp, UZA, Edegem, Belgium.
Cosyns
P
P
Maes
L
L
D'Hondt
P
P
Schotte
C
C
D000328:Adult; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000145:classification* / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology