Anxious-retarded depression: relation to family history of depression.
Anxious-retarded depression is a two-dimensionally defined subcategory of depression based on high scores for both anxiety and retardation. The anxious-retarded subcategory is related to melancholia as defined by DSM-IV. Patients with this diagnosis exhibit elevated plasma arginine vasopressin (AVP) and a high correlation between plasma vasopressin and cortisol, which suggests vasopressinergic overactivation of the hypothalamus-pituitary-adrenal (HPA) axis. In this report, we present the multidimensional derivation of the anxious-retarded subcategory from DSM-IV melancholia, and a second step in the validation of this anxious-retarded subcategory by exploring its relation to family history of depression. The patient sample comprised 89 patients with major depression and encompassed 66 patients investigated previously regarding plasma AVP and cortisol. All patients were rated for the following three dimensions of psychopathology: autonomic dysregulation (anxiety), motivational inhibition (retardation), and emotional dysregulation, as well as for family history of depression. The dependence of DSM-IV melancholia on the sum scores and the dichotomized scores on the three dimensions was investigated by multiple logistic regression. Thereafter, the dependence of the family history for depression on the same parameters was also investigated. The melancholic subcategory depended on the interaction between the sum scores, as well as on the interaction between the dichotomized scores for anxiety and retardation that constitute the anxious-retarded subcategory. Family history for depression depended only on the interaction of the dichotomized scores, and thus on the anxious-retarded subcategory.
de Winter
Remco F P
RF
Department of Psychiatry, Leiden University Medical Center, Oegstgeest, The Netherlands.
Zwinderman
Koos H
KH
Goekoop
Jaap G
JG
D000328:Adult; D017668:Age of Onset; D001007:Anxiety / Q000453:epidemiology* / Q000378:metabolism; D001127:Arginine Vasopressin / Q000097:blood; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000235:genetics* / Q000378:metabolism; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology; D012720:Severity of Illness Index
D001127:Arginine Vasopressin; D006854:Hydrocortisone