Abstract
<h3>In Reply.—</h3> The statements in the<i>second</i>paragraph of Dr Pitts' letter to the editor require clarification. First, since most patients with affective disorder have an episodic course of illness, a history of a cluster of depressive symptoms for a given period of time<i>is</i>the basis for a diagnosis of primary affective disorder in the absence of a preexisting psychiatric disorder. Second, the term "primary affective disorder" is preferable to "manic-depressive psychosis"<sup>1</sup>since the presence of neither psychosis nor mania (or even depression if mania is present) is required for the establishment of the presence of an affective disorder, the cause of which is unknown.<sup>2</sup>Third, there are no laboratory tests to confirm a diagnosis of primary affective disorder as there are for tuberculosis, where clinical findings can be supported or confirmed by such tests. Fourth, we found the prevalence of primary affective disorder among the female physicians to
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