Response set and observer set in the assessment of depressed patients

SynopsisDepressed patients were rated at a psychiatric interview and completed a self-report symptom inventory. Concordance between the two measures was modest. Patients with psychotic depression and those with obsessional personalities were found to rate themselves low on self-report relative to interview assessments. Younger patients, and those showing neuroticism, hysterical, and oral dependent personalities rated themselves as more severely ill than did the clinician. These systematic discrepancies appeared to reflect a self-report response set to exaggerate or minimize psychiatric symptoms together with rater set regarding certain types of patients.</jats:p

Recent life events in schizophrenia and depression

SYSNOPSISDepressives and matched first admission schizophrenics were compared with respect to life events experienced in the six months before the onset of illness. Depressives reported more events than schizophrenics, but this excess involved only certain types of events. Depressives reported more exits from the social field, and a variety of undesirable events, particularly those involving interpersonal arguments. They reported no more events in some other classes. These findings support previous work involving life events, particularly exits and undesirable events in the genesis of depression, and indicate that qualitative implications of events influence their effects.</jats:p

Effects of maintenance amitriptyline and psychotherapy on symptoms of depression

SynopsisDepressives responding to initial treatment were maintained on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly onto no medication. In each group half the patients received weekly psychotherapy and half were seen, once monthly. Effects on symptom ratings were examined. Maintenance amitriptyline gave a significant advantage over early withdrawal in preventing symptom recrudescence. There were no differences between double-blind or overt withdrawal. There were no interactions between drug withdrawal and psychotherapy. Psychotherapy produced no significant advantages over low contact on symptoms, although it did improve social adjustment ratings reported elsewhere.</jats:p

Prognosis of depression and the endogenous-neurotic distinction

SYNOPSISDepressed patients were followed-up after 10 months, and factor scores reflecting respectively general severity, the endogenous-neurotic distinction, and an admixture of anxiety versus depression were used as predictors. The main prognostic relationships were with the endogenous-neurotic distinction and provided validating evidence for it. Endogenous depressives showed generally better prognoses. Individual rating variables used to derive the factors showed little relationship to outcome and prediction appeared to derive from a summation of elements relevant to the endogenous-neurotic distinction across many variables.</jats:p