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Clinical Research in Depression

Clinical Research in Depression Abstract Despite impressive advances in research and therapy, our theories of clinical depression remain rooted in 19th-century concepts derived from experiences with hospitalized and psychotic patients. Current clinical experience, however, is mainly with nonpsychotic and noninstitutionalized patients. Unresolved problems include: the role of life experience in depression, delineation of psychopathologic states from normal emotional reactions, classifications and differentiation of types of depression, the need for better predictors of treatment response, and social and clinical criteria for outcome studies. These issues will be discussed within the framework of an adaptational approach which attempts to bridge recent developments in neuropharmacology, therapeutics, and clinical research. References 1. Hock PH, Zubin J (eds): Depression . New York, Grune & Stratton Inc, 1954. 2. Schou M: Biology and pharmacology of the lithium ion . Pharmacol Rev 9:17-58, 1957. 3. Gershon S, Yuwiler A: Lithium ion: A specific psychopharmacological approach to the treatment of mania . J Neuropsychiat 1:229-241, 1960. 4. Cade JFJ: Lithium salts in the treatment of psychotic excitement . Med J Aust 2:349-352, 1949. 5. Klerman GL, Cole JO: Clinical pharmacology of imipramine and related antidepressant compounds . Pharmacol Rev 17:101-141, 1965. 6. Cohen MB, Baker G, Cohen RS, et al: An intensive study of twelve cases of manic-depressive psychosis . Psychiatry 17:103-137, 1954. 7. Spiegel JB, Bell NW: The family of the psychiatric patient , in Arieti S (ed): American Handbook of Psychiatry . New York, Basic Books Inc Publishers, 1959, vol 1, pp 114-149. 8. Deykin EY, Klerman GL, Armor DJ: The relatives of schizophrenic patients: Clinical judgments of potential emotional resourcefulness . Amer J Psychiat 36:510-528, 1966. 9. Gibson RW: The family background and early life experiences of the manic-depressive patient . Psychiatry 21:71-90, 1958. 10. Jacobson S, Klerman GL: Interpersonal dynamics of hospitalized depressed patients home visits . J Marriage Family 28:94-102, 1966.Crossref 11. Klerman GL, Paykel ES: Depressive pattern, social background and hospitalization . J Nerv Ment Dis 150:466-478, 1970.Crossref 12. Schildkraut JJ, Davis JM, Klerman GL: Biochemistry of depression , in Efron D (ed): Psychopharmacology: A Review of Progress, 1957-1967 . Chevy Chase, Md, US Dept of Health, Education, and Welfare, 1968, pp 625-648. 13. Beck AT: Depression . New York, Harper & Row Publishers Inc, 1967. 14. Gershon S, Holmberg G, Mattsson E, et al: Imipramine hydrochloride: Its effects on clinical, autonomic, and psychological functions . Arch Gen Psychiat 6:96-101, 1962.Crossref 15. Hartmann EL: Sleep and dream patterns in manic-depressive patients. Read before the sixth annual meeting of the Association for the Psychophysiological Study of Sleep, Gainesville, Fla, 1966. 16. Hawkins DR, Mendels J: Sleep disturbances in depressive syndromes . Amer J Psychiat 123:682-690, 1966. 17. Kaplan SM, Kravwtz RS, Ross WD: The effects of imipramine on the depressive components of medical disorders, in Proceedings of Third World Congress of Psychiatry. Montreal, University of Toronto Press and McGill University Press, 1961, vol 2, pp 1362-1367. 18. Bowlby J: Attachment . New York, Basic Books Inc Publishers, 1969. 19. Engel G: Affect in Engel G (ed): Psychological Development in Health and Disease . Philadelphia, WB Saunders Co, 1962, pp 123-129. 20. Winokur G, Pitts FN: Affective disorder: II. A family history study of prevalence, sex difference and possible genetic factors . J Psychiat Res 3:113-123, 1965.Crossref 21. McKinney WT, Bunney WE Jr: Animal model of depression . Arch Gen Psychiat 21:240-248, 1969.Crossref 22. Senay EC: Toward an animal model of depression: A study of separation behavior in dogs . J Psychiat Res 4:65-71, 1966.Crossref 23. Farberow NL, Schneiddeman ES: A Cry for Help . New York, McGraw-Hill Book Co Inc, 1961. 24. Gillespie RD: The clinical differentiation of types of depression . Guy Hosp Rep 2:306-344, 1929. 25. Meyer A: A discussion on the classification of the melancholies . J Nerv Ment Dis 32:114, 1905. 26. Chassen JC: Research Design in Clinical Psychology and Psychiatry . New York, Appleton-Century-Crofts, 1967. 27. Klerman GL: Clinical phenomenology of depression: Implications for research strategy in the psychobiology of the affective disorders. Read before the NIMH Workshop on Psychobiology of Depression, College of William and Mary, Williamsburg, Va, 1969. 28. Paykel ES, Klerman GL, Prusoff BA: Treatment setting and clinical depression . Arch Gen Psychiat 22:11-21, 1970.Crossref 29. Raskin A: Preliminary findings of NIMH collaborative study of drug treatment of depression. Read before the Conference on Early Clinical Drug Evaluation, Montreal, 1967. 30. Paykel EP, Prusoff BA, Klerman GL: The endogenous-neurotic dimension in depression: Rater independence and factor distributions. J Psychiat Res, to be published. 31. Mendels J, Cochran C: The nosology of depression: The endogenous-reactive concept . Amer J Psychiat 124( (suppl) ):1-11, 1968. 32. Robins E, Munoz RA, Marten S, et al: Primary and secondary affective disorders: A classification for description, research, and management of mood disorders: Preliminary report of 314 patients seen in an emergency room, in Zubin J, Freyhan F (eds): Mood Disorders. New York, Grune & Stratton Inc, to be published. 33. Freud S: Mourning and melancholia , in Collected Papers . London, Hogarth Press Ltd, 1956, vol 4. 34. Kraepelin E: Manic-Depressive Insanity and Paranoia . M Barclay (trans), Edinburgh, E & S Livingston Ltd, 1921. 35. Rosenthal S, Gudeman JE: The endogenous pattern of depressive illness: An empirical replication . Arch Gen Psychiat 16:241-249, 1967.Crossref 36. Lewis AJ: Melancholia: Clinical survey of depressive states . J Ment Sci 80:277-378, 1934. 37. Meyer-Gross W, Slater E, Roth M: Clinical Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1968. 38. Robins E, Guze SB: Classification of affective disorders: The primary-secondary, the endogenousreactive, and the neurotic-psychotic concepts, in Williams TA, Katz MM, and Shield JA Jr (eds): Recent Advances in the Psychobiology of the Depressive Illnesses: Proceedings of a Workshop sponsored by NIMH. US Government Printing Office, to be published. 39. Rosenthal S, Klerman GL: Content and consistency in the endogenous depressive pattern . Brit J Psychiat 112:471-484, 1966.Crossref 40. Menninger K: The Vital Balance . New York, Viking Press Inc, 1963. 41. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiat 23:56-62, 1960.Crossref 42. Fenichel O: The Psychoanalytical Theory of Neurosis . New York, WW Norton & Co Inc Publishers, 1945, pp 401-406. 43. Kiloh LG, Garside RF: The independence of neurotic depression and endogenous depression . Brit J Psychiat 109:451-453, 1963.Crossref 44. Grinker RR, Miller J, Sabshin M, et al: The Phenomena of Depressions . New York, Paul B Hoeber Inc, 1961. 45. Bibring E: The mechanism of depression , Disorders. in Greenacre P (ed): Affective Disorders . New York, International Universities Press, 1953. 46. Friedman AS, Cowitz B, Cohen HW, et al: Syndromes and themes of psychotic depression . Arch Gen Psychiat 9:504-509, 1963.Crossref 47. Mendelson M: Psychoanalytic Concepts of Depression . Springfield, Ill, Charles C Thomas Publisher, 1960. 48. Bellak L, Rosenberg S: Effects of antidepressant drugs on psychodynamics . Psychosomatics 7:106-114, 1966.Crossref 49. Gershon ES, Cromer M, Klerman GL: Hostility and depression . Psychiatry 31:224-235, 1968. 50. Rapaport D: Edward Bibring's theory of depression , in Collected Papers of David Rapaport . New York, Basic Books Inc Publishers, 1967, pp 758-773. 51. Abraham K: Notes on the psychoanalytical investigation and treatment of manic-depressive insanity and allied conditions , in Selected Papers on Psychoanalysis . London, Hogarth Press Ltd, 1911. 52. Abraham K: A short study of the development of the libido , in Selected Papers of Karl Abraham , M.D. London, Hogarth Press Ltd, 1927. 53. Hamilton M, White JM: Clinical syndromes in depressive states . J Ment Sci 105:985-998, 1959. 54. Overall JE: Dimensions of manifest depression . Psychiat Res 1:239-245, 1962.Crossref 55. Lazare A, Klerman GL: Hysteria and depression: The frequency and significance of hysterical personality features in hospitalized depressed women . Amer J Psychiat 124 ( (suppl) ):48-56, 1968. 56. Katz MM, Cole JO, Barton WE: The Role and Methodology of Classification in Psychiatry and Psychology . Chevy Chase, Md, US Dept of Health, Education, and Welfare, 1965. 57. Kendell RE: The Classification of Depressive Illness , Maudsley Monograph No. 18. London, Oxford University Press, 1968. 58. Grinker RR, Werble B, Drye RC: The Borderline Syndrome . New York, Basic Books Inc Publishers, 1968. 59. Paykel ES: Classification of depressed patients: A cluster analysis derived grouping. Brit J Psychiat, to be published. 60. Paykel ES, Prusoff BA, Klerman GL, et al: Clinical response to amitriptyline among depressed women: Typological and regression approaches to prediction. Read before the Eighth Annual Meeting of the American College of Neuropsychopharmacology, San Diego, Calif, 1970. 61. Kety SS: Biochemical theories of schizophrenia . Science 29:1590-1596, 1959.Crossref 62. Sachar EJ, MacKenzie JM, Binstock WA, et al: Corticosteroid responses to psychotherapy of depressions: I. Evaluations during confrontation of loss . Arch Gen Psychiat 16:461-470, 1967.Crossref 63. Klein DF, Fink M: Psychiatric reaction patterns to imipramine . Amer J Psychiat 119:432, 1962. 64. Hill D: Depression: Disease, reaction, or posture . Amer J Psychiat 125:37-49, 1968. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Clinical Research in Depression

Archives of General Psychiatry , Volume 24 (4) – Apr 1, 1971

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References (61)

Publisher
American Medical Association
Copyright
Copyright © 1971 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1971.01750100015003
Publisher site
See Article on Publisher Site

Abstract

Abstract Despite impressive advances in research and therapy, our theories of clinical depression remain rooted in 19th-century concepts derived from experiences with hospitalized and psychotic patients. Current clinical experience, however, is mainly with nonpsychotic and noninstitutionalized patients. Unresolved problems include: the role of life experience in depression, delineation of psychopathologic states from normal emotional reactions, classifications and differentiation of types of depression, the need for better predictors of treatment response, and social and clinical criteria for outcome studies. These issues will be discussed within the framework of an adaptational approach which attempts to bridge recent developments in neuropharmacology, therapeutics, and clinical research. References 1. Hock PH, Zubin J (eds): Depression . New York, Grune & Stratton Inc, 1954. 2. Schou M: Biology and pharmacology of the lithium ion . Pharmacol Rev 9:17-58, 1957. 3. Gershon S, Yuwiler A: Lithium ion: A specific psychopharmacological approach to the treatment of mania . J Neuropsychiat 1:229-241, 1960. 4. Cade JFJ: Lithium salts in the treatment of psychotic excitement . Med J Aust 2:349-352, 1949. 5. Klerman GL, Cole JO: Clinical pharmacology of imipramine and related antidepressant compounds . Pharmacol Rev 17:101-141, 1965. 6. Cohen MB, Baker G, Cohen RS, et al: An intensive study of twelve cases of manic-depressive psychosis . Psychiatry 17:103-137, 1954. 7. Spiegel JB, Bell NW: The family of the psychiatric patient , in Arieti S (ed): American Handbook of Psychiatry . New York, Basic Books Inc Publishers, 1959, vol 1, pp 114-149. 8. Deykin EY, Klerman GL, Armor DJ: The relatives of schizophrenic patients: Clinical judgments of potential emotional resourcefulness . Amer J Psychiat 36:510-528, 1966. 9. Gibson RW: The family background and early life experiences of the manic-depressive patient . Psychiatry 21:71-90, 1958. 10. Jacobson S, Klerman GL: Interpersonal dynamics of hospitalized depressed patients home visits . J Marriage Family 28:94-102, 1966.Crossref 11. Klerman GL, Paykel ES: Depressive pattern, social background and hospitalization . J Nerv Ment Dis 150:466-478, 1970.Crossref 12. Schildkraut JJ, Davis JM, Klerman GL: Biochemistry of depression , in Efron D (ed): Psychopharmacology: A Review of Progress, 1957-1967 . Chevy Chase, Md, US Dept of Health, Education, and Welfare, 1968, pp 625-648. 13. Beck AT: Depression . New York, Harper & Row Publishers Inc, 1967. 14. Gershon S, Holmberg G, Mattsson E, et al: Imipramine hydrochloride: Its effects on clinical, autonomic, and psychological functions . Arch Gen Psychiat 6:96-101, 1962.Crossref 15. Hartmann EL: Sleep and dream patterns in manic-depressive patients. Read before the sixth annual meeting of the Association for the Psychophysiological Study of Sleep, Gainesville, Fla, 1966. 16. Hawkins DR, Mendels J: Sleep disturbances in depressive syndromes . Amer J Psychiat 123:682-690, 1966. 17. Kaplan SM, Kravwtz RS, Ross WD: The effects of imipramine on the depressive components of medical disorders, in Proceedings of Third World Congress of Psychiatry. Montreal, University of Toronto Press and McGill University Press, 1961, vol 2, pp 1362-1367. 18. Bowlby J: Attachment . New York, Basic Books Inc Publishers, 1969. 19. Engel G: Affect in Engel G (ed): Psychological Development in Health and Disease . Philadelphia, WB Saunders Co, 1962, pp 123-129. 20. Winokur G, Pitts FN: Affective disorder: II. A family history study of prevalence, sex difference and possible genetic factors . J Psychiat Res 3:113-123, 1965.Crossref 21. McKinney WT, Bunney WE Jr: Animal model of depression . Arch Gen Psychiat 21:240-248, 1969.Crossref 22. Senay EC: Toward an animal model of depression: A study of separation behavior in dogs . J Psychiat Res 4:65-71, 1966.Crossref 23. Farberow NL, Schneiddeman ES: A Cry for Help . New York, McGraw-Hill Book Co Inc, 1961. 24. Gillespie RD: The clinical differentiation of types of depression . Guy Hosp Rep 2:306-344, 1929. 25. Meyer A: A discussion on the classification of the melancholies . J Nerv Ment Dis 32:114, 1905. 26. Chassen JC: Research Design in Clinical Psychology and Psychiatry . New York, Appleton-Century-Crofts, 1967. 27. Klerman GL: Clinical phenomenology of depression: Implications for research strategy in the psychobiology of the affective disorders. Read before the NIMH Workshop on Psychobiology of Depression, College of William and Mary, Williamsburg, Va, 1969. 28. Paykel ES, Klerman GL, Prusoff BA: Treatment setting and clinical depression . Arch Gen Psychiat 22:11-21, 1970.Crossref 29. Raskin A: Preliminary findings of NIMH collaborative study of drug treatment of depression. Read before the Conference on Early Clinical Drug Evaluation, Montreal, 1967. 30. Paykel EP, Prusoff BA, Klerman GL: The endogenous-neurotic dimension in depression: Rater independence and factor distributions. J Psychiat Res, to be published. 31. Mendels J, Cochran C: The nosology of depression: The endogenous-reactive concept . Amer J Psychiat 124( (suppl) ):1-11, 1968. 32. Robins E, Munoz RA, Marten S, et al: Primary and secondary affective disorders: A classification for description, research, and management of mood disorders: Preliminary report of 314 patients seen in an emergency room, in Zubin J, Freyhan F (eds): Mood Disorders. New York, Grune & Stratton Inc, to be published. 33. Freud S: Mourning and melancholia , in Collected Papers . London, Hogarth Press Ltd, 1956, vol 4. 34. Kraepelin E: Manic-Depressive Insanity and Paranoia . M Barclay (trans), Edinburgh, E & S Livingston Ltd, 1921. 35. Rosenthal S, Gudeman JE: The endogenous pattern of depressive illness: An empirical replication . Arch Gen Psychiat 16:241-249, 1967.Crossref 36. Lewis AJ: Melancholia: Clinical survey of depressive states . J Ment Sci 80:277-378, 1934. 37. Meyer-Gross W, Slater E, Roth M: Clinical Psychiatry , ed 3. Baltimore, Williams & Wilkins Co, 1968. 38. Robins E, Guze SB: Classification of affective disorders: The primary-secondary, the endogenousreactive, and the neurotic-psychotic concepts, in Williams TA, Katz MM, and Shield JA Jr (eds): Recent Advances in the Psychobiology of the Depressive Illnesses: Proceedings of a Workshop sponsored by NIMH. US Government Printing Office, to be published. 39. Rosenthal S, Klerman GL: Content and consistency in the endogenous depressive pattern . Brit J Psychiat 112:471-484, 1966.Crossref 40. Menninger K: The Vital Balance . New York, Viking Press Inc, 1963. 41. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiat 23:56-62, 1960.Crossref 42. Fenichel O: The Psychoanalytical Theory of Neurosis . New York, WW Norton & Co Inc Publishers, 1945, pp 401-406. 43. Kiloh LG, Garside RF: The independence of neurotic depression and endogenous depression . Brit J Psychiat 109:451-453, 1963.Crossref 44. Grinker RR, Miller J, Sabshin M, et al: The Phenomena of Depressions . New York, Paul B Hoeber Inc, 1961. 45. Bibring E: The mechanism of depression , Disorders. in Greenacre P (ed): Affective Disorders . New York, International Universities Press, 1953. 46. Friedman AS, Cowitz B, Cohen HW, et al: Syndromes and themes of psychotic depression . Arch Gen Psychiat 9:504-509, 1963.Crossref 47. Mendelson M: Psychoanalytic Concepts of Depression . Springfield, Ill, Charles C Thomas Publisher, 1960. 48. Bellak L, Rosenberg S: Effects of antidepressant drugs on psychodynamics . Psychosomatics 7:106-114, 1966.Crossref 49. Gershon ES, Cromer M, Klerman GL: Hostility and depression . Psychiatry 31:224-235, 1968. 50. Rapaport D: Edward Bibring's theory of depression , in Collected Papers of David Rapaport . New York, Basic Books Inc Publishers, 1967, pp 758-773. 51. Abraham K: Notes on the psychoanalytical investigation and treatment of manic-depressive insanity and allied conditions , in Selected Papers on Psychoanalysis . London, Hogarth Press Ltd, 1911. 52. Abraham K: A short study of the development of the libido , in Selected Papers of Karl Abraham , M.D. London, Hogarth Press Ltd, 1927. 53. Hamilton M, White JM: Clinical syndromes in depressive states . J Ment Sci 105:985-998, 1959. 54. Overall JE: Dimensions of manifest depression . Psychiat Res 1:239-245, 1962.Crossref 55. Lazare A, Klerman GL: Hysteria and depression: The frequency and significance of hysterical personality features in hospitalized depressed women . Amer J Psychiat 124 ( (suppl) ):48-56, 1968. 56. Katz MM, Cole JO, Barton WE: The Role and Methodology of Classification in Psychiatry and Psychology . Chevy Chase, Md, US Dept of Health, Education, and Welfare, 1965. 57. Kendell RE: The Classification of Depressive Illness , Maudsley Monograph No. 18. London, Oxford University Press, 1968. 58. Grinker RR, Werble B, Drye RC: The Borderline Syndrome . New York, Basic Books Inc Publishers, 1968. 59. Paykel ES: Classification of depressed patients: A cluster analysis derived grouping. Brit J Psychiat, to be published. 60. Paykel ES, Prusoff BA, Klerman GL, et al: Clinical response to amitriptyline among depressed women: Typological and regression approaches to prediction. Read before the Eighth Annual Meeting of the American College of Neuropsychopharmacology, San Diego, Calif, 1970. 61. Kety SS: Biochemical theories of schizophrenia . Science 29:1590-1596, 1959.Crossref 62. Sachar EJ, MacKenzie JM, Binstock WA, et al: Corticosteroid responses to psychotherapy of depressions: I. Evaluations during confrontation of loss . Arch Gen Psychiat 16:461-470, 1967.Crossref 63. Klein DF, Fink M: Psychiatric reaction patterns to imipramine . Amer J Psychiat 119:432, 1962. 64. Hill D: Depression: Disease, reaction, or posture . Amer J Psychiat 125:37-49, 1968.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Apr 1, 1971

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