The role of psychosocial and biological variables in separating chronic and non-chronic major depression and early-late-onset dysthymia.
Psychosocial (sociodemographic characteristics, loss and separation and family atmosphere in childhood, recent life events) and biological (family history, DST, TRH-test) variables were investigated in 180 patients with Major Depression (MD) and Dysthymic Disorder (DD). The aim of the study was to reveal certain differences between the chronic and non-chronic course of MD and the early- and late-onset subtypes of dysthymia. When comparing the two course patterns of MD, a higher rate of malignant tumours among first-degree relatives, a greater number of long-lasting stress situations before the index depressive episode, longer duration of the previous episodes, less frequent DST nonsuppression, and a blunted TSH response to TRH were found in patients with a chronic course of MD. Several factors seem to influence the course pattern of MD, or else the chronic form represents a subgroup within MD. The late-onset dysthymics were mainly women with a low level of education, a lower suicidal tendency, normal suppression in DST, and a lack of blunted TSH responses to TRH administration during the period of double depression. The early-onset dysthymics showed a higher number of persons who had never married, who presented a more traumatic and frustrating childhood background, and who had a higher rate of DST non-suppressors and blunted TSH responses after TRH administration during the period of their double depression. Our data suggest that late-onset dysthymia might be a biologically distinct subgroup of chronic depression.
Szádóczky
E
E
Department of Psychiatry and Clinical Psychology, Postgraduate Medical University, Budapest, Hungary.
Fazekas
I
I
Rihmer
Z
Z
Arató
M
M
D000293:Adolescent; D000328:Adult; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D002675:Child, Preschool; D002908:Chronic Disease; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification* / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D003907:Dexamethasone; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000145:classification* / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D012931:Social Environment; D013406:Suicide, Attempted / Q000523:psychology; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone
D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D013972:Thyrotropin; D006854:Hydrocortisone