Neurotic and Psychotic Forms of Depressive Illness: Evidence from Age-Incidence in a National Sample

Abstract

The ability to distinguish separate types of disorder among patients who seem at first sight to have similar symptoms has been a powerful factor in the progress of medicine. It is for this reason that the attempt to distinguish different varieties of depressive illness is important. In Britain recent studies have been concerned with the presence (as rated by the examining physician) of various symptoms and signs which from clinical experience have been thought likely to distinguish a neurotic from a psychotic type of depression. The investigators agree on the presence of these two types but disagree on the nature of the distinction, one school holding that there are two largely distinct types of illness and the other that the types merely represent the opposite ends of a continuum. The holders of the latter view accept that there may well be distinct types of depressive illness, but maintain that, if so, they cannot be distinguished by present methods of clinical examination. The divergence of view has been attributed by Kendell (1968) to sampling differences and to the subjective bias of raters, and by Eysenck (1970) to disagreement on whether the two types of depressive illness are of a categorical nature (i.e. specific disease entities) or of a dimensional nature (i.e. each has a graded distribution in a population of depressed patients).

The Validity of the ICD-10 Classification of Recurrent Affective Disorders: Do Endogenous and Psychogenic Depressions Form a Homogeneous Diagnostic Group?

“…The age distribution and age differences between patients with endogenous versus psychogenic depression agreed with those reported in the literature [16][17][18][19][20]. Other authors, however, have found an age difference 5 years lower.…”

Incidence of depression in octo- and nonagenerians: results of an epidemiological follow-up community study

“…Incidence studies for depression concerning only psychiatric inpatients (Adelstein 1968;Spicer 1973;Bland 1977;Eagles 1985) are not comparable to our study. The degree of severity of illness and factors of illness behavior and help seeking behavior influence the treatment, and general conclusions cannot be drawn.…”

“…Presently, such longitudinal studies on the incidence of depression are rare. Differences in diagnostic procedures and case identification and sampling are most likely responsible for considerable variations in the incidence rates obtained in these studies (Murphy 1988;Spicer 1973).…”

Mania in old age: A First Prospective Study

“…However, two other studies (Spicer et a/., 1973;Eagles and Whalley, 1985) which used national statistics of first admissions to psychiatric hospitals in the United Kingdom showed a different trend. Eagles and Whalley found that the number of first admissions with mania remained steady with age.…”