Neurotic depression: a diagnosis based on preexisting characteristics.

A neurotic depression is a depression in an emotionally unstable person. Secondary depressions to major personality disorders, neuroses, and drug use disorders fit the above definition. Likewise, primary depressions with a family history of alcohol (depression spectrum disease) are characterized by a long history of stormy life problems and, therefore, would fit the definition. Using these two preexisting characteristics, we examined a group of 401 neurotic depressives and compared them to 536 nonneurotic (endogenous) depressives. The neurotic depressives were younger and the neurotic patients had made more previous suicide attempts. They were less likely to show memory deficits or delusions and less likely to show symptom criteria of melancholia. They were more likely to have suicide thoughts at index. Treatment was more effective in the nonneurotic patients and such patients made fewer suicide attempts in follow-up. These differences confirm the validity of the distinction between neurotic and nonneurotic depression.