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April 17, 1981, Vol 245, No. 15 >
ARTICLE | April 17, 1981

Diagnosis of Depression in the 1980s FREE

Mark S. Gold, MD; A. L. C. Pottash, MD; Irl Extein, MD; Donald R. Sweeney, MD, PhD
[+] Author Affiliations

Reprint requests to Basic Research, Psychiatric Diagnostic Laboratory, 19 Prospect St, Summit, NJ 07901 (Dr Gold).


JAMA. 1981;245(15):1562-1564. doi:10.1001/jama.1981.03310400044029
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References

DEPRESSION is the most common of psychiatric symptoms and occurs in many psychiatric illnesses. Major depressive disorder can be distinguished by sleep and appetite disturbances and other "hypothalamic" signs and symptoms.1-4 Major depression can be subdivided into unipolar and bipolar depressive illness on the basis of a history of mania in bipolar illness (Fig 1), and into primary and secondary depression.1-4 Secondary depression and minor depressive illness occur in medical illness and in nonaffective psychiatric illness such as obsessive-compulsive neurosis, personality disorders, schizophrenia, drug and alcohol dependence, and sexual dysfunction, respectively. These categories (Fig 1) have been helpful in improving diagnostic reliability between psychiatrists and reducing heterogeneity in diagnostic groups. They improve understanding of pathophysiology and facilitate prediction of treatment response and prognosis. Biologic tests have been developed that can support a clinical impression or diagnosis. A number of important biochemical subgroups of unipolar major depression can be

REFERENCES

1 +
Guze SB, Woodruff RA, Clayton PJ:  Secondary affective disorder: A study of 95 cases . Psychol Med 1971;;1:426-428.
2 +
Feighner JP, Robins E, Guze SB, et al:  Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;;26:57-63.
3 +
Sweeney DR, Maas JW, Heninger GR:  State anxiety, physical activity, and urinary 3-methoxy 4-hydroxyphenethylene glycol excretion . Arch Gen Psychiatry 1978;;35:1418-1423.
4 +
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria , ed 3. New York, New York State Division of Mental Health, Biometrics Research, 1977;.
5 +
Schlesser M, Winokur G, Sherman BM:  Hypothalamic-pituitary-adrenal axis activity in depressive illness . Arch Gen Psychiatry 1980;; 37:737-743.
6 +
Brown WA, Shuey I:  Response to dexamethasone and subtype of depression . Arch Gen Psychiatry 1980;;37:747-751.
7 +
Sachar EJ, Asnis G, Nathan RS, et al:  Dextroamphetamine and cortisol in depression . Arch Gen Psychiatry 1980;;37:755-757.
8 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 1976;;33:1039-1044.
9 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from non-depressed patients . Arch Gen Psychiatry 1976;;33:1051-1058.
10 +
Sweeney DR, Maas JW:  Specificity of depressive disease . Annu Rev Med 1978;;29:219-229.
11 +
Extein I, Pottash ALC, Gold MS:  TRH test in depression . N Engl J Med 1980;;302:923-924.
12 +
Gold MS, Pottash ALC, Ryan N, et al:  TRH-induced TSH response in unipolar, bipolar, and secondary depressions: Possible utility in clinical assessment and differential diagnosis . Psychoneuroendocrinology 1980;;5:147-155.
13 +
Gold MS, Pottash ALC, Davies RK, et al:  Distinguishing unipolar and bipolar depression by thyrotropin release test . Lancet 1979;;2:411-413.
14 +
Greden JF, Albala AA, Haskett RF, et al:  Normalization of dexamethasone suppression test: A laboratory index of recovery from endogenous depression . Biol Psychiatry 1980;;15:449-458.
15 +
Gold MS, Pottash ALC, Extein I, et al:  Dexamethasone suppression tests in depression and response to treatment . Lancet 1980;;1:1190.
16 +
Ettigi P, Brown GM:  Psychoneuroendocrinology of affective disorders: An overview . Am J Psychiatry 1977;;134:493-501.
17 +
Kirkegaard C, Norlem N, Lauridsen UB, et al:  Prognostic value of thyrotropin-releasing hormone stimulation test in endogenous depression , abstracted. Acta Psychiatr Scand 1975;; 52:170-177.
18 +
Sachar EJ, Asnis G, Halbreich U, et al:  Recent studies in the neuroendocrinology of major depressive disorders , in Sachar EJ (ed): Psychiatric Clinics of North America . Philadelphia, WB Saunders Co, 1980;, vol 3, pp 313-326.
19 +
Prange AJ Jr, Wilson IC, Lara PP, et al:  Effects of thyrotropin-releasing hormone in depression . Lancet 1972;;2:999-1002.
20 +
Goodwin FK, Cowdry RW, Webster MH:  Predictors of drug response in the affective disorders: Toward an integrated approach , in Lipton MA, DiMascio A, Killam KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 1277-1288.
21 +
Kupfer DJ: REM latency:  A psychobiologic marker for primary depressive disease . Biol Psychiatry 1976;;11:159-174.

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1 +
Guze SB, Woodruff RA, Clayton PJ:  Secondary affective disorder: A study of 95 cases . Psychol Med 1971;;1:426-428.
2 +
Feighner JP, Robins E, Guze SB, et al:  Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;;26:57-63.
3 +
Sweeney DR, Maas JW, Heninger GR:  State anxiety, physical activity, and urinary 3-methoxy 4-hydroxyphenethylene glycol excretion . Arch Gen Psychiatry 1978;;35:1418-1423.
4 +
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria , ed 3. New York, New York State Division of Mental Health, Biometrics Research, 1977;.
5 +
Schlesser M, Winokur G, Sherman BM:  Hypothalamic-pituitary-adrenal axis activity in depressive illness . Arch Gen Psychiatry 1980;; 37:737-743.
6 +
Brown WA, Shuey I:  Response to dexamethasone and subtype of depression . Arch Gen Psychiatry 1980;;37:747-751.
7 +
Sachar EJ, Asnis G, Nathan RS, et al:  Dextroamphetamine and cortisol in depression . Arch Gen Psychiatry 1980;;37:755-757.
8 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 1976;;33:1039-1044.
9 +
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from non-depressed patients . Arch Gen Psychiatry 1976;;33:1051-1058.
10 +
Sweeney DR, Maas JW:  Specificity of depressive disease . Annu Rev Med 1978;;29:219-229.
11 +
Extein I, Pottash ALC, Gold MS:  TRH test in depression . N Engl J Med 1980;;302:923-924.
12 +
Gold MS, Pottash ALC, Ryan N, et al:  TRH-induced TSH response in unipolar, bipolar, and secondary depressions: Possible utility in clinical assessment and differential diagnosis . Psychoneuroendocrinology 1980;;5:147-155.
13 +
Gold MS, Pottash ALC, Davies RK, et al:  Distinguishing unipolar and bipolar depression by thyrotropin release test . Lancet 1979;;2:411-413.
14 +
Greden JF, Albala AA, Haskett RF, et al:  Normalization of dexamethasone suppression test: A laboratory index of recovery from endogenous depression . Biol Psychiatry 1980;;15:449-458.
15 +
Gold MS, Pottash ALC, Extein I, et al:  Dexamethasone suppression tests in depression and response to treatment . Lancet 1980;;1:1190.
16 +
Ettigi P, Brown GM:  Psychoneuroendocrinology of affective disorders: An overview . Am J Psychiatry 1977;;134:493-501.
17 +
Kirkegaard C, Norlem N, Lauridsen UB, et al:  Prognostic value of thyrotropin-releasing hormone stimulation test in endogenous depression , abstracted. Acta Psychiatr Scand 1975;; 52:170-177.
18 +
Sachar EJ, Asnis G, Halbreich U, et al:  Recent studies in the neuroendocrinology of major depressive disorders , in Sachar EJ (ed): Psychiatric Clinics of North America . Philadelphia, WB Saunders Co, 1980;, vol 3, pp 313-326.
19 +
Prange AJ Jr, Wilson IC, Lara PP, et al:  Effects of thyrotropin-releasing hormone in depression . Lancet 1972;;2:999-1002.
20 +
Goodwin FK, Cowdry RW, Webster MH:  Predictors of drug response in the affective disorders: Toward an integrated approach , in Lipton MA, DiMascio A, Killam KF (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 1277-1288.
21 +
Kupfer DJ: REM latency:  A psychobiologic marker for primary depressive disease . Biol Psychiatry 1976;;11:159-174.

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