Nondepressive Disorders Research Articles

Suicidal Behaviors and Childhood-Onset Depressive Disorders: A Longitudinal Investigation

In this longitudinal study, the rates and correlates of suicidal ideation and suicide attempts were determined among outpatient youths with depressive disorders and youths with other psychiatric disorders. At study entry, about 66% of the subjects evidenced suicidal ideation and 9% already attempted suicide. The rate of ideation remained fairly stable over time, whereas the rate of attempts reached 24% by the average age of 17 years. Major depressive and dysthymic disorders were associated with significantly higher rates of suicidal behaviors than were adjustment disorder with depressed mood and nondepressive disorders. In the presence of affective disorders, comorbid conduct and/or substance use disorders further increased the risk of suicide attempts.

Validation of the Children's Depression Scale and the Children's Depression Inventory in a prepubertal sample.

The validity of the Children's Depression Scale (CDS), the Children's Depression Inventory (CDI) and their respective parent report versions was assessed in a sample of outpatient and normal control prepubertal children. Scores from the child and parent versions of both scales significantly discriminated between children independently diagnosed as depressed and those with nondepressive disorders. Both measures also distinguished depressed and dysphoric children. Contrary to the findings of earlier studies, a significant rate of agreement was found between the reports provided by the children and their parents. The results suggest that the influence of the child's age and clinical status on reporter correspondence patterns should be considered more exhaustively in future research.

Depressive illness: the role of aggression further considered.

Measures of depression and undischarged drive were obtained for 292 psychiatric in-patients. In 200 of these cases inhibition of aggression was also assessed. All patients were classified as being endogenously depressed, reactively depressed, or as suffering from non-depressive primary disorders. The latter group was subdivided into secondarily depressed and non-depressed groups. The 3 depressed groups were then compared with the non-depressed subjects in respect of drive level and inhibition of aggressionmall 3 depressed groups showed significantly higher driver level than did the non-depressed subjects. The endogenous depressives also inhibited significantly more of their aggression than did the non-depressed subjects. The results are consistent with a drive inhibition theory of depression. However, while endogenous depression seems to be associated more specifically with the inhibition of aggression, reactive depression may be associated rather with the inhibition of drive generally.

Neuroendocrine regulation in depression. II. Discrimination of depressed from nondepressed patients.

Forty-two patients with endogenomorphic depression (ED) and 42 patients with other psychiatric disorders received an overnight dexamethasone test of hypothalamopituitary-adrenal (HPA) suppressibility. Plasma and urinary cortisol measures showed that the ED patients had significantly greater HPA activity before dexamethasone and less complete HPA suppression after dexamethasone. High cortisol vlaues after dexamethasone correlated strongly with spontaneous HPA disinhibition, as indicated by high baseline midnight plasma cortisol levels. Criteria for defining normal suppression responses were developed. All patients with depressive neuroses and most patients with other nondepressive disorders had completely normal responses to dexamethasone. About half of the ED patients had abnormal responses, whether or not they were receiving other drugs at the time of the test. Drug-free patients with depressive neuroses or other disorders showed no abnormal responses to dexamethasone. The effects of psychotropic drugs on the test require further study. Patients with two or more abnormal cortisol values after administration of dexamethasone were identified correctly as ED at confidence levels close to 100%. The dexamethasone suppression test may be of value as a laboratory aid in the diagnosis of "endogenous" depression.