Winokur G, Black D W, Nasrallah A
Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242.
Am J Psychiatry. 1988 Feb;145(2):233-7. doi: 10.1176/ajp.145.2.233.
The authors studied 401 patients with depressions secondary to psychiatric illnesses (substance abuse disorders or somatoform, anxiety, or personality disorders) or depressions secondary to medical illnesses. They found that the patients with depressions secondary to psychiatric illnesses had an earlier age at onset, were more likely to have suicidal thoughts or to have made suicide attempts, were less likely to have memory problems, were less improved with treatment and more likely to relapse on follow-up, and had more alcoholism in their families than patients with depressions secondary to medical illnesses. Depressions secondary to medical illnesses seem to fit the category of reactive depression, and depressions secondary to psychiatric illnesses fit the definition of neurotic depression.
作者对401例继发于精神疾病(物质滥用障碍或躯体形式障碍、焦虑症或人格障碍)或继发于内科疾病的抑郁症患者进行了研究。他们发现,继发于精神疾病的抑郁症患者起病年龄较早,更有可能有自杀念头或曾尝试自杀,记忆力问题较少,治疗效果较差且随访时更易复发,其家族中酗酒者比继发于内科疾病的抑郁症患者更多。继发于内科疾病的抑郁症似乎符合反应性抑郁症的范畴,而继发于精神疾病的抑郁症符合神经症性抑郁症的定义。