Kantor S J, Glassman A H
Br J Psychiatry. 1977 Oct;131:351-60. doi: 10.1192/bjp.131.4.351.
A review of the abundant literature concerning the distinction between delusional and non-delusional depressions, especially of the work of Aubrey Lewis, reveals that before the introduction of specific therapies most in-patients with major depressive illness eventually recovered; the small percentage who did not almost all came from the delusional group. The dichotomy lost its clinical significance after the introduction of ECT, as both groups were equally responsive. However, accumulating evidence indicates that unipolar delusional depressives are significantly less responsive to tricyclic anti-depressant therapy than non-delusional depressives. The presence or absence of delusional thinking should be considered as a significant criterion in the classification of depressive disorders, and the presence or absence of delusional thinking should influence the choice of treatment for severely depressed patients.
对大量有关妄想性抑郁症与非妄想性抑郁症区别的文献进行回顾，尤其是奥布里·刘易斯的研究工作，结果显示，在特定疗法出现之前，大多数重度抑郁症住院患者最终康复；少数未康复的患者几乎都来自妄想性抑郁症组。在引入电休克疗法（ECT）之后，这种二分法失去了临床意义，因为两组的反应相同。然而，越来越多的证据表明，单相妄想性抑郁症患者对三环类抗抑郁药治疗的反应明显低于非妄想性抑郁症患者。妄想思维的存在与否应被视为抑郁症分类的一个重要标准，并且妄想思维的存在与否应影响重度抑郁症患者的治疗选择。
