Anxious, irritable and hostile depression re-appraised.

BACKGROUND

While classification of the depression disorders currently favors a dimensional model, this study considered the empirical support for a spectrum model linking personality with phenotypic depressive features, specifically examining patients with 'irritable', 'hostile' and 'anxious' depression.

METHODS

Pearson correlations were performed for Temperament and Personality (T&P) scales and state depressive patterns (irritable, hostile and anxious) for patients clinically diagnosed with unipolar melancholic and non-melancholic depressive conditions.

RESULTS

Irritable depression was most strongly associated with T&P irritability and anxious depression with T&P anxious-worrying - although these associations lacked specificity and were also correlated with other T&P scales. Hostile depression was most strongly correlated with T&P irritability suggesting that hostile and irritable depression are synonymous patterns. There were no clear indications for more distinct associations for the non-melancholic, compared to the melancholic, subset.

LIMITATIONS

Study findings are limited in that measures of state depressive patterns were relatively minimalistic and assignment to melancholic and non-melancholic conditions was measured by clinician judgment and may be subjective in nature.

CONCLUSIONS

Findings offer little support in the positioning of anxious and irritable/hostile depression as meaningfully differing patterns, nor for the spectrum model being more specific to the non-melancholic depressive conditions. There would appear to be little utility in preserving these depressive patterns as diagnostic constructs.