Separation of subtypes of depression using discriminant analysis: Separation of bipolar endogenous depression from nonendogenous (“Neurotic”) depression

Abstract

We derived a discriminant function separating patients with bipolar endogenous depression (“melancholia”) from patients with nonendogenous (“neurotic”) depression, and showed that the difference between the groups was not one of overall severity of illness alone. The discriminant function (DF) included 5 clinical items. We reduced the DF to a discriminant index (DI) with integral item weights, and trichotomized the DI scores into two definite classifications and an intermediate, uncertain classification. We cross-validated this DI in a separate group of patients, and found no decrease in the accuracy of classification on cross-validation. Thirty-three of 41 (80%) of the patients in the cross-validation group were classified by the DI; 26 of 33 (79%) correctly. We also validated the DI classification against an external, biological marker, the dexamethasone suppression test (DST). The DI predicted the DST result with the same accuracy as the clinical diagnoses did, supporting the validity of the DI.