Cultural variations in premorbid personality of endogenous depression: a transcultural study.

The triplet Typus Melancholicus proposed by Tellenbach (1961), endogenous depression, a good response to antidepressants, seems to give a form of clearly defined entity. In this study comparing Typus Melancholicus in Japan and in France, we have tried to differentiate the essential elements which vary according to culture. Thirty-eight patients corresponding to major depression (DSM-III-R) hospitalized in our clinics in Japan and in France and their families have been questioned during and after the pathological episodes using a method of our own devising. In Japan, Typus Melancholicus is generally respected and socially well integrated because of its first characteristic, or "orderliness with consideration to others." For that reason in the premorbid life, it is usually free from manifest conflict, and its personality is remarkably homogeneous. In France the opposite is true with the range of variations being wide with a high frequency of neurotic aspects. This may be due to the malfunction of "the orderliness with consideration to others" in France, where individualism is dominant. We have found two general types of variants, named "hypercommon" and "hypernormative." These two directions correspond to the elements that compose Typus Melancholicus: patients of the first group have a tendency to adapt to other's point of view; patients of the second group have a tendency to be under the pressure of a sense of obligation toward norms.