Andrews G, Neilson M, Hunt C, Stewart G, Kiloh L G
Clinical Research Unit for Anxiety Disorders, University of New South Wales, St Vincent's Hospital, Sydney, Australia.
Br J Psychiatry. 1990 Jul;157:13-8. doi: 10.1192/bjp.157.1.13.
Patients diagnosed in the late 1960s as suffering from either endogenous or neurotic depression, or as presenting with depression but discharged with another neurotic diagnosis, were followed for 15 years. Diagnosis at index admission did not predict overall outcome, but patients with endogenous depression, an apparently stable diagnosis, had longer index admissions, were readmitted sooner, but spent less time ill than patients in either of the neurosis groups. Personality abnormality accounted for 20% of the variance in outcome in the neurotic groups and only 2% of the variance in the endogenous group. Thus there is evidence that endogenous and neurotic depression are two illnesses and that, in the neuroses particularly, prognosis will depend on the extent to which these personality abnormalities are modified by treatment.
对20世纪60年代末被诊断患有内源性抑郁症或神经症性抑郁症，或表现为抑郁症但出院时被诊断为其他神经症的患者进行了15年的随访。首次入院时的诊断并不能预测总体预后，但内源性抑郁症患者（一种明显稳定的诊断）首次住院时间更长，再次入院更早，但患病时间比神经症组中的任何一组患者都短。人格异常在神经症组的预后差异中占20%，而在内源性抑郁症组中仅占2%。因此，有证据表明内源性抑郁症和神经症性抑郁症是两种疾病，尤其是在神经症中，预后将取决于治疗对这些人格异常的改善程度。
