Nelson J C, Charney D S, Quinlan D M
J Nerv Ment Dis. 1980 Nov;168(11):637-43. doi: 10.1097/00005053-198011000-00001.
The records of 172 depressed inpatients were examined retrospectively to determine the presenting symptoms, history of stress, clinical course, and personality features characteristic of patients whose depressive syndrome had become autonomous. The autonomous distinction was based on observation of a lack of responsiveness of the syndrome to environmental events during the first week of hospitalization prior to drug treatment. The autonomous criterion was selected since it is a central characteristic of recent psychobiological models of depression and it could be operationally defined, reliably rated, and assessed independently of other patient characteristics. Sixty-eight autonomous patients were identified and compared with 104 patients who were responsive to hospitalization. The characteristics of the autonomous patients are discussed in relation to the previous literature, other diagnostic systems, and the criteria proposed for the diagnosis of melancholia in DSM-III.
对172例抑郁症住院患者的记录进行了回顾性检查，以确定那些抑郁综合征已发展为自主性的患者的初始症状、应激史、临床病程及人格特征。自主性的区分基于在药物治疗前住院第一周期间对该综合征对环境事件缺乏反应性的观察。选择自主性标准是因为它是近期抑郁症心理生物学模型的核心特征，并且可以进行操作性定义、可靠评分，且独立于其他患者特征进行评估。识别出68例自主性患者，并与104例对住院治疗有反应的患者进行比较。结合既往文献、其他诊断系统以及DSM-III中提出的忧郁症诊断标准，对自主性患者的特征进行了讨论。
