Secondary affective disorder in women with somatization disorder.

Of 60 women with somatization disorder (SD), 54 (90%) met DSM-III criteria for a major affective episode. This group with secondary affective disorder (SAD) was compared with 29 women who had primary affective disorder (PAD). SAD patients reported significantly more symptoms, more psychiatric admissions, more and longer episodes of depression; more had attempted suicide, and more had made multiple attempts. SAD patients had often been hospitalized and were likely to have been treated with lithium and a variety of antidepressants. Studying relatively homogeneous primary psychiatric diagnoses facilitates the identification of distinctions between SAD and PAD patients.