Elsevier

Psychiatry Research

Volume 34, Issue 1, October 1990, Pages 29-41
Psychiatry Research

Clinical subtypes of unipolar depression: Part I. A validation of the vital and nonvital clusters

https://doi.org/10.1016/0165-1781(90)90056-BGet rights and content

Abstract

Cluster analyses were carried out on a sample of 100 depressed females. The study was based on the 14 items relevant to depressive phenomenology of the Structured Clinical Interview for DSM-III-R (SCID). Our findings support the existence of two classes, i.e., a vital (melancholic) vs. a nonvital cluster. The vital cluster is characterized by the following symptoms: a distinct quality of depressed mood, nonreactivity, early morning awakening, anorexia-weight loss, and cognitive and psychomotor disturbances. Patients belonging to the vital cluster exhibit disorders in the hypothalamic-pituitary-adrenal and thyroid axes and a markedly decreased availability of L-trytophan to the brain. The vital depressives score significantly higher on the Hamilton Rating Scale for Depression as compared to those suffering from nonvital depression. The cluster-analytically derived class of vital depression and the DSM-III subtype of melancholia tend to be quite similar. Our findings support the isolation and the descriptive validity of a vital (melancholic) depressive syndrome.

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Michael Maes, M.D., is a Psychiatric Ward of the University Hospital of Antwerp, Unit of Clinical Psychobiology. Paul Cosyns, M.D., is Professor of Psychiatry, University Hospital of Antwerp. Leo Maes, Ph.D., is Director, Laboratory for Analytical Chemistry, CTL Institute, Ghent. Peter D'Hondt, M.D., is Research Assistant, University of Antwerp (UZA). Chris Schotte is a Clinical and Research Psychologists in the Unit of Clinical Psychobiology, University Hospital of Antwerp.

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