Neuroendocrine Dysfunction in Subtypes of Depression

  • Detlev Von Zerssen
  • Mathias Berger
  • Peter Doerr


As pointed out by G. M. Brown and associates in their contribution to this volume, “neuroendocrine function may provide a means of differentiating various subtypes among the affective disorders, because they may mirror the central activity of biogenic amines in depressed subjects. Different types of neurotransmitter deficit have been postulated in depressive illness. Different underlying abnormalities could lead to syndromes which differ with respect to clinical characteristics, visceral symptomatology, and endocrine abnormalities.” They have listed a series of endocrine abnormalities of depressed patients as described in the literature and added information about their own findings on neuroendocrine effects of lithium (see also Prange and Loosen, this volume; Johnson, 1982; Sachar, 1982; Winokur et al., 1982).


Anorexia Nervosa Depressed Patient Insulin Tolerance Test Depressive Illness Dexamethasone Suppression Test 
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  1. Amsterdam, J. D., Winokur, A., Caroff, S. N., and Conn, J., 1982, The dexamethasone suppression test in outpatients with primary affective disorder and healthy control subjects, Am. J. Psychiatry 139:287.PubMedGoogle Scholar
  2. Aro, A., Lamberg, B.-A., and Pelkonen, R., 1978, Endocrine changes in anorexia nervosa, Acta Endocrinol. (Kbh.) Suppl. 220:(89):16.Google Scholar
  3. Benkert, O., Klein, H. E., Hofschuster, E., and Seibold, C., 1981, Effect of the anticholinergic drug biperiden on pituitary hormones and Cortisol, Psychoneuwendocrinology 6:231.CrossRefGoogle Scholar
  4. Berger, M., Doerr, P., Lund, R., Bronisch, T., and von Zerssen, D., 1982a, Neuroendokrinolo-gische Befunde und polygraphische Schlafuntersuchungen bei Patienten mit depressiven Syndromen, in: Biologische Psychiatrie (H. Beckmann, ed.), pp. 205–210, Thieme, Stuttgart.Google Scholar
  5. Berger, M., Doerr, P., Lund, R., Bronisch, T., and von Zerssen, D., 1982b, Neuroendocrinological and neurophysiological studies in major depressive disorders: Are there biological markers for the endogenous subtype?, Biol. Psychiatry 17:1217–1242.PubMedGoogle Scholar
  6. Berger, M., Krieg, C., and Pirke, K. M., 1982c, Is the positive dexamethasone test in depressed patients a consequence of weight loss?, Neuroendocrinal. Lett. 4:177.Google Scholar
  7. Berger, M., Lund, R., Bronisch, T., and von Zerssen, D., 1983a, REM latency in neurotic and endogenous depression and the cholinergic REM induction test, Psychiatry Res., in press.Google Scholar
  8. Berger, M., Pirke, K. M., Doerr, P., Krieg, C., and von Zerssen, D., 1983b, Influence of weight loss on the dexamethasone suppression test, Arch. Gen. Psychiatry 40:585.PubMedCrossRefGoogle Scholar
  9. Bleuler, M., 1964, Endokrinologische psychiatrie, in: Psychiatrie der Gegenwart (H. W. Gruhle, R. Jung, W. Mayer-Gross, and M. Mueller, eds.), Vol. 1/1, pp. 161–252, Springer, Berlin.Google Scholar
  10. Brambilla, F., Smeraldi, E., Sacchetti, E., Negri, F., Cocchi, D., and Müller, E. E., 1978, Deranged anterior pituitary responsiveness to hypothalamic hormones in depressed patients, Arch. Gen. Psychiatry 35:1231.PubMedCrossRefGoogle Scholar
  11. Bridges, P. K., Jones, M. T., and Leak, D., 1970, A taxonomic study of physiological responses to a psychological stress, J. Neurol. Neurosurg. Psychiatry 33:180.PubMedCrossRefGoogle Scholar
  12. Carney, M. W. P., Roth, M., and Garside, R. F., 1965, The diagnosis of depressive syndromes and the prediction of E.C.T. response, Br. J. Psychiatry 111:659.PubMedCrossRefGoogle Scholar
  13. Carroll, B. J., 1979, Neuroendocrine function in mania, in: Manic Illness (B. Shopsin, ed.), pp. 163–176, Raven Press, New York.Google Scholar
  14. Carroll, B. J., 1980, Neuroendocrine aspects of depression: Theoretical and practical significance, in: The Psychobiology of Affective Disorders (J. Mendels and J. D. Amsterdam, eds.), pp. 99–110, Karger, Basel.Google Scholar
  15. Carroll, B. J., 1982, The dexamethasone suppression test for melancholia, Br. J. Psychiatry 140:292.PubMedCrossRefGoogle Scholar
  16. Carroll, B. J., and Mendels, J., 1976, Neuroendocrine regulation in affective disorders, in: Hormones, Behavior, and Psychopathology (E. J. Sachar, ed.), pp. 193–224, Raven Press, New York.Google Scholar
  17. Carroll, B. J., Curtis, G. C., Davies, B. M., Mendels, J., and Sugerman, A. A., 1976a, Urinary free Cortisol excretion in depression, Psychol. Med. 6:43.PubMedCrossRefGoogle Scholar
  18. Carroll, B. J., Curtis, G. C., and Mendels, J., 1976b, Neuroendocrine regulation in depression. I. Limbic system-adrenocortical dysfunction, Arch. Gen. Psychiatry 33:1039.PubMedCrossRefGoogle Scholar
  19. Carroll, B. J., Curtis, G. C., and Mendels, J., 1976c, Neuroendocrine regulation in depression. II. Discrimination of depressed from nondepressed patients, Arch. Gen. Psychiatry 33:1051.PubMedCrossRefGoogle Scholar
  20. Carroll, B. J., Feinberg, M., Greden, J. F., Haskett, R. F., James, N. M., Steiner, M., and Tarika, J., 1980a, Diagnosis of endogenous depression, J. Affect. Dis. 2:177.PubMedCrossRefGoogle Scholar
  21. Carroll, B. J., Greden, J. F., and Feinberg, M., 1980b, Neuroendocrine disturbances and the diagnosis and aetiology of endogenous depression, Lancet I:321.CrossRefGoogle Scholar
  22. Carroll, B. J., Greden, J. F., Haskett, R., Feinberg, M., Albala, A. A., Martin, F. I. R., Rubin, R. T., Heath, B., Sharp, P. T., McLeod, W. L., and McLeod, M. F., 1980c, Neurotransmitter studies of neuroendocrine pathology in depression, Acta Psychiatr. Scand. Suppl. 280(61):183.PubMedGoogle Scholar
  23. Carroll, B. J., Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R. F., James, N. M., Kronfol, Z., Lohr, N., Steiner, M., de Vigne, J.-P., and Young, E., 1981, A specific laboratory test for the diagnosis of melancholia, Arch. Gen. Psychiatry 38:15.PubMedCrossRefGoogle Scholar
  24. Checkley, S. A., 1979, Corticosteroid and growth hormone responses to methylamphetamine in depressive illness, Psychol. Med. 9:107.PubMedCrossRefGoogle Scholar
  25. Checkley, S. A., 1980, Neuroendocrine tests of monoamine function in man: A review of basic theory and its application to the study of depressive illness, Psychol. Med. 10:35.PubMedCrossRefGoogle Scholar
  26. Cohen, S. I., 1980, Cushing’s syndrome: A psychiatric study of 29 patients, Br. J. Psychiatry 136:120.PubMedCrossRefGoogle Scholar
  27. Coryell, W., Gaffney, G., and Burkhardt, P. E., 1982a, The dexamethasone suppression test and familial subtypes of depression—A naturalistic replication, Biol. Psychiatry 17:33.PubMedGoogle Scholar
  28. Coryell, W., Gaffney, G., and Burkhardt, P. E., 1982b, DSM-III melancholia and the primary-secondary distinction: A comparison of concurrent validity by means of the dexamethasone suppression test, Am. J. Psychiatry 139:120.PubMedGoogle Scholar
  29. Czernik, A., 1982, Zur Psychophysiologic und Neuroendokrinologie von Depressionen, Springer, Berlin.CrossRefGoogle Scholar
  30. Davis, B. M., Davis, K. L., 1980, Cholinergic mechanisms and anterior pituitary hormone secretion, Biol. Psychiatry 15:303.PubMedGoogle Scholar
  31. Dirlich, G., Kammerloher, A., Schulz, H., Lund, R., Doerr, P., and von Zerssen, D., 1981, Temporal coordination of rest-activity cycle, body temperature, urinary free Cortisol, and mood in a patient with 48-hour unipolar-depressive cycles in clinical and time-cue-free environments, Biol. Psychiatry 16:163.PubMedGoogle Scholar
  32. Doerr, P., and Berger, M., 1983, Physostigmine-induced escape from dexamethasone suppression in normal adults, Biol. Psychiatry 18:261.PubMedGoogle Scholar
  33. Doerr, P., and von Zerssen, D., 1983, Die circadiane Ausscheidung an freiem Harncortisol waeh-rend der depressiven Phase und im freien Intervall bei Patienten mit einer endogenen Depression, in: Depressionen (V. Faust and G. Hole, eds.), pp. 142–150, Hippokrates, Stuttgart.Google Scholar
  34. Doerr, P., von Zerssen, D., Fischler, M., and Schulz, H., 1979, Relationship between mood changes and adrenal cortical activity in a patient with 48-hour unipolar-depressive cycles, J. Affect. Disorders 1:93.PubMedCrossRefGoogle Scholar
  35. Doerr, P., Fichter, M., Pirke, K. M., and Lund, R., 1980, Relationship between weight gain and hypothalamic pituitary adrenal function in patients with anorexia nervosa, J. Steroid Biochem. 13:529.PubMedCrossRefGoogle Scholar
  36. Emrich, H. M., Lund, R., and von Zerssen, D., 1979, Vegetative Funktionen und körperliche Aktivität in der endogenen Depression: Verlaufsuntersuchungen von Speichelsekretion, Temperatur und Motorik bei einem Patienten mit 48-Stunden-Zyklus, Arch. Psychiatr. Nervenkr. 227:227.PubMedCrossRefGoogle Scholar
  37. Fehm, H. L., Steiner, K., and Voigt, K. H., Methamphetamine-induced Cortisol secretion in man is not mediated by ACTH, in: Integrative Neurohumoral Mechanisms (L. Angelucci, D. de Wied, E. Endroeczi, and U. Scapagnini, eds.), Elsevier, Amsterdam, in press.Google Scholar
  38. Fichter, M. M., and Pirke, K. M., 1982, Somatische Befunde bei Anorexia nervosa und ihre differentialdiagnostische Wertigkeit, Nervenarzt 53:635.PubMedGoogle Scholar
  39. Fichter, M. M., Doerr, P., Pirke, K. M., and Lund, R., 1982 Behavior, attitude, nutrition and endocrinology in anorexia nervosa: A longitudinal study in 24 patients, Acta Psychiatr. Scand. 66:429.PubMedCrossRefGoogle Scholar
  40. Greden, J. F., de Vigne, J.-P., Albala, A. A., Tarika, J., Buttenheim, M., Eiser, A., and Carroll, B. J., 1982, Serial dexamethasone suppression tests among rapidly cycling bipolar patients, Biol. Psychiatry 17:455.PubMedGoogle Scholar
  41. Gruen, P. H., Sachar, E. J., Altman, N., and Sassin, J., 1975, Growth hormone responses to hypoglycemia in postmenopausal depressed women, Arch. Gen. Psychiatry 32:31.PubMedCrossRefGoogle Scholar
  42. Holsboer, F., Bender, W., Benkert, O., Klein, H. E., and Schmauss, M., 1980, Diagnostic value of dexamethasone suppression test in depression, Lancet 11:706.CrossRefGoogle Scholar
  43. Holsboer, F., Liebl, R., and Hofschuster, E., 1982, Repeated dexamethasone suppression test during depressive illness—Normalization of test result with clinical improvement, J. Affect. Disorders 4:93.PubMedCrossRefGoogle Scholar
  44. Hopkinson, G., 1981, A neurochemical theory of appetite and weight changes in depressive states, Acta Psychiatr. Scand. 64:217.PubMedCrossRefGoogle Scholar
  45. Janowsky, D. S., Risch, C., Parker, D., Huey, L., and Judd, L., 1980, Increased vulnerability to cholinergic stimulation in affective-disorder patients, Psychopharmacol. Bull. 16:29.PubMedGoogle Scholar
  46. Jeffcoate, W. J., Silverstone, J. T., Edwards, C. R. W., and Besser, G. M., 1979, Psychiatric manifestations of Cushing’s syndrome: Response to lowering of plasma Cortisol, Q. J. Med. 191:465.Google Scholar
  47. Johnson, G. F. S., 1982, Endocrine dysfunction in depression, in: Handbook of Psychiatry and Endocrinology (P. J. V. Beumont and G. D. Burrows, eds.), pp. 239–266, Elsevier, Amsterdam.Google Scholar
  48. Jones, M. T., Gillham, B., Di Renzo, G., Beckford, U., and Holmes, M. C., 1981, Neural control of corticotrophin secretion, in: Frontiers of Hormone Research, Vol. 8, ACTH and LPH in Health and Disease (T. B. van Wimersma Greidanus and L. H. Rees, eds.), pp. 12–43, Karger, Basel.Google Scholar
  49. Kalin, N. H., Cohen, R. M., Kraemer, G. W., Risch, S. C., Shelton, S., Cohen, M., McKinney, W. T., and Murphy, D. L., 1981, The dexamethasone suppression test as a measure of hy-pothalamic-pituitary feedback sensitivity and its relationship to behavioral arousal, Neuroendocrinology 32:92.PubMedCrossRefGoogle Scholar
  50. Katz, J. L., Boyar, R. M., Weiner, H., Gorzynski, G., Roffwarg, H., and Hellman, L., 1976, Toward an elucidation of the psychoendocrinology of anorexia nervosa, in: Hormones, Behavior, and Psychopathology (E. J. Sachar, ed.), pp. 263–283, Raven Press, New York.Google Scholar
  51. Kendler, K. S., and Davis, K. L., 1977, Elevated corticosteroids as a possible cause of abnormal neuroendocrine function in depressive illness, Commun. Psychopharmacol. 1:183.PubMedGoogle Scholar
  52. Koslow, S. H., Stokes, P. E., Mendels, J., Ramsey, A., and Casper, R., 1982, Insulin tolerance test: Human growth hormone response and insulin resistance in primary unipolar depressed, bipolar depressed and control subjects, Psychol. Med. 12:45.PubMedCrossRefGoogle Scholar
  53. Krieger, D. T., 1982, Cushing’s Syndrome, Springer, Berlin.CrossRefGoogle Scholar
  54. Ling, M. H. M., Perry, P. J., and Tsuang, M. T., 1981, Side effects of corticosteroid therapy, Arch. Gen. Psychiatry 38:471.PubMedCrossRefGoogle Scholar
  55. Kendler, K. S., and Davis, K. L., 1977, Elevated corticosteroids as a possible cause of abnormal neuroendocrine function in depressive illness, Commun. Psychopharmacol. 1:183–194.PubMedGoogle Scholar
  56. Lorr, M., and Klett, C. J., 1967, Inpatient Multidimensional Psychiatric Scales (IMPS), revised manual, Consulting Psychologists Press, Palo Alto, Calif.Google Scholar
  57. Marton, K. I., Sox, H. C., Jr., and Krupp, J. R., 1981, Involuntary weight loss: Diagnostic and prognostic significance, Ann. Intern. Med. 95:568.PubMedGoogle Scholar
  58. Mason, J. W., 1975, Psychologic stress and endocrine function, in: Topics in Psychoneuro endocrinology (E. J. Sachar, ed.), pp. 1–18, Grune & Stratton, New York.Google Scholar
  59. Mason, J. W., Sachar, E. J., Fishman, J. R., Hamburg, D. A., and Handlon, J. H., 1965, Corticosteroid responses to hospital admission, Arch. Gen. Psychiatry 13:1.PubMedCrossRefGoogle Scholar
  60. Matussek, N. M., Ackenheil, M., Hippius, H., Müller, F., Schröder, H. T., Schultes, H., and Wasilewski, B., 1980, Effect of Clonidine on growth hormone release in psychiatric patients and controls, Psychiatry Res. 2:25.PubMedCrossRefGoogle Scholar
  61. Nathan, R. S., Sachar, E. J., Asnis, G. M., Halbreich, U., and Halpern, F. S., 1981, Relative insulin insensitivity and Cortisol secretion in depressed patients, Psychiatry Res. 4:291.PubMedCrossRefGoogle Scholar
  62. Nurnberger, J. I., Jimerson, D. C., Simmons, S., Tamminga, C., Suzan Nadi, N., and Gershon, E. S., 1982, Responses to arecoline in normal twins and “well state” patients with affective disorder, Presented at the Society of Biological Psychiatry, 37th Annual Convention, Toronto, p. 91.Google Scholar
  63. Pirke, K. M., and Spyra, B., 1982, Catecholamine turnover in the brain and the regulation of luteinizing hormone and corticosterone in starved male rats, Acta Endocrinol. (Kbh) 100:168.Google Scholar
  64. Pirke, K. M., Fichter, M., Lund, R., and Doerr, P., 1980, Die Ausschuettung des luteinisierenden Hormons waehrend des Schlafens und Wachens bei Patienten mit Anorexia nervosa, Aktuel. Endokrinol. Stoffwechsel 1:147.Google Scholar
  65. Pirke, K. M., Fichter, M. M., Holsboer, F., Kempin, W., Weiss, W., and Wolfram, G., 1982, 24-hour sleep-wake cycle of LH and Cortisol during starvation in healthy subjects and in anorexia nervosa, Acta Endocrinol. (Kbh.) Suppl. 246(99):83.Google Scholar
  66. Rose, R. M., 1980, Endocrine responses to stressful psychological events, in: Psychiatric Clinics of North America: Advances in Psychoneuroendocrinology, Vol. 3/2 (E. J. Sachar, ed.), pp. 251–276, Saunders, Philadelphia.Google Scholar
  67. Rudorfer, M. V., Hwu, H.-G., and Clayton, P. J., 1982, Dexamethasone suppression test in primary depression: Significance of family history and psychosis, Biol. Psychiatry 17:41.PubMedGoogle Scholar
  68. Russell, G., 1977, The present status of anorexia nervosa, Psychol. Med. 7:363.PubMedCrossRefGoogle Scholar
  69. Sachar, E. J., 1967, Corticosteroids in depressive illness. I. A réévaluation of control issues and the literature, Arch. Gen. Psychiatry 17:544.CrossRefGoogle Scholar
  70. Sachar, E. J., 1975, Neuroendocrine abnormalities in depressive illness, in: Topics in Psychoen-docrinology (E. J. Sachar, ed.), pp. 135–156, Grune & Stratton, New York.Google Scholar
  71. Sachar, E. J., 1982, Endocrine abnormalities in depression, in: Handbook of Affective Disorders (E. S. Paykel, ed.), pp. 191–201, Churchill Livingstone, Edinburgh.Google Scholar
  72. Sachar, E. J., Asnis, G., Nathan, R. S., Halbreich, U., Tabrizi, M. A., and Halpern, F. S., 1980, Dextroamphetamine and Cortisol in depression, Arch. Gen. Psychiatry 37:755.PubMedCrossRefGoogle Scholar
  73. Schildkraut, J. J., Orsulak, P. J., Schatzberg, A. F., Gudeman, J. E., Cole, J. O., Rohde, W. A., and LaBrie, R. A., 1978, Toward a biochemical classification of depressive disorders. I. Differences in urinary excretion of MHPG and other catecholamine metabolites in clinically defined subtypes of depressions, Arch. Gen. Psychiatry 35:1427.PubMedCrossRefGoogle Scholar
  74. Schlesser, M. A., Winokur, G., and Sherman, B. M., 1980, Hypothalamic-pituitary-adrenal axis activity in depressive illness: Its relationship to classification, Arch. Gen. Psychiatry 31:131.Google Scholar
  75. Schulz, H., 1981, Sleep onset REM episodes in depression, in: Sleep 1980 (W. P. Koella, ed.), pp. 72–84, Karger, Basel.Google Scholar
  76. Schulz, H., Lund, R., Cording, C., and Dirlich, G., 1979, Bimodal distribution of REM sleep latencies in depression, Biol. Psychiatry 14:595.PubMedGoogle Scholar
  77. Shulman, R., and Diewold, P., 1977, A two-dose dexamethasone suppression test in patients with psychiatric illness, Can. Psychiatrl. Assoc. J. 22:417.Google Scholar
  78. Sitaram, N., Nurnberger, J. I., Gershon, E. S., and Gillin, J. C., 1982, Cholinergic regulation of mood and REM sleep: Potential model and marker of vulnerability to affective disorder, Am. J. Psychiat. 139:571.PubMedGoogle Scholar
  79. Spitzer, R. L., Endicott, J., and Robins, E., 1978, Research diagnostic criteria: Rationale and reliability, Arch. Gen. Psychiatry 35:773.PubMedCrossRefGoogle Scholar
  80. Stokes, P. E., Stoll, P. M., Mattson, M. R., and Sollod, R. N., 1976, Diagnosis and psychopathology in psychiatric patients resistant to dexamethasone, in: Hormones, Behavior, and Psychopathology (E. J. Sachar, ed.), pp. 225–229, Raven Press, New York.Google Scholar
  81. Targum, S. D., Byrnes, S. M., and Sullivan, A. C., 1982, Subtypes of unipolar depression distinguished by the dexamethasone suppression test, J. Affect. Disorders 4:21.PubMedCrossRefGoogle Scholar
  82. Träskman, L., Tybring, G., Åsberg, M., Bertilsson, L., Lantto, O., and Schalling, D., 1980, Cortisol in the CSF of depressed and suicidal patients, Arch. Gen. Psychiatry 37:761.PubMedCrossRefGoogle Scholar
  83. Vale, W., Rivier, C., Yang, L., Minick, S., and Guilleman, R., 1978, Effects of purified hypothalamic corticotropin-releasing factor and other substances on the secretion of adrenocorti-cotropin and β-endorphin-like immunoactivities in vitro, Endocrinology 103:1910.PubMedCrossRefGoogle Scholar
  84. Voigt, K. H., Weber, E., Fehm, H. L., and Martin, R., 1980, The concomitant storage and simultaneous release of ACTH and β-endorphin, in: Brain and Pituitary Peptides (W. Wuttke, A. Weindl, K. H. Voigt, and R.-R. Dries, eds.), pp. 54–64, Karger, Basel.Google Scholar
  85. Voigt, K. H., Bossert, S., Bretschneider, S., Rockstroh, B., and Fehm, H. L., Disturbance of Cortisol secretion in depressive patients: Lack of correlation with plasma ACTH, in: Integrative Neurohumoral Mechanisms (L. Angelucci, D. de Wied, E. Endroeczi, and U. Scapagnini, eds.), Elsevier, Amsterdam, in press.Google Scholar
  86. von Zerssen, D., 1976, Mood and behavioral changes under corticosteroid therapy, in: Psychotropic Action of Hormones (T. M. Itil, G. Laudahn, and W. M. Herrmann, eds.), pp. 195–222, Spectrum, New York.Google Scholar
  87. von Zerssen, D., and Cording, C., 1978, The measurement of change in endogenous affective disorders, Arch. Psychiatr. Nervenkr. 226:95.CrossRefGoogle Scholar
  88. von Zerssen, D., and Doerr, P., 1980, The role of the hypothalamo-pituitary-adrenocortical system in psychiatric disorders, Adv. Biol. Psychiatry 5:85.Google Scholar
  89. von Zerssen, D., Dirlich, G., and Fischler, M., The influence of an abnormal time routine and therapeutic measures on 48-hour cycles of affective disorders: Chronobiological considerations, in: Circadian Rhythms in Psychiatry (T. A. Wehr and F. K. Goodwin, eds.), Boxwood Press, Los Angeles, in press.Google Scholar
  90. Walsh, B. T., Katz, J. L., Levin, J., Kream, J., Fukushima, D. K., Hellman, L. D., Weiner, H., and Zumoff, B., 1978, Adrenal activity in anorexia nervosa, Psychosom. Med. 40:499.PubMedGoogle Scholar
  91. Whybrow, P. C., and Hurwitz, T., 1976, Psychological disturbances associated with endocrine disease and hormone therapy, in: Hormones, Behavior, and Psychopathology (E.J. Sachar, ed.), pp. 125–143, Raven Press, New York.Google Scholar
  92. Winokur, A., Amsterdam, J., Caroff, S., Snyder, P. J., and Brunswick, D., 1982, Variability of hormonal responses to a series of neuroendocrine challenges in depressed patients, Am. J. Psychiatry 139:39.PubMedGoogle Scholar
  93. World Health Organization, 1974, Glossary of Mental Disorders and Guide to Their Classification for Use in Conjunction with the Internal Classification of Diseases, 8th Rev., Geneva.Google Scholar

Copyright information

© Plenum Publishing Corporation 1984

Authors and Affiliations

  • Detlev Von Zerssen
    • 1
  • Mathias Berger
    • 1
  • Peter Doerr
    • 1
  1. 1.Max-Planck-Institut für PsychiatrieMunichGermany

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