Family History Studies
Numerous efforts have been made to categorize the varieties of affective disorder. The obvious way to provide such a differentiation would be on the basis of the clinical picture. Recently, Kiloh and Garside  presented a careful study of patients with affective disorders in which they subjected to a factor analysis 35 clinical features obtained from 31 patients with a “reasonably certain” clinical diagnosis of endogenous depression and 61 patients with a “reasonably certain” diagnosis of neurotic depression. These clinical features included personal details, personality traits, previous history of attacks of depression, and symptoms of the present illness. Their data enabled them to differentiate between neurotic and endogenous depression. Such features as early morning awakening, retardation, diurnal variation, and weight loss correlated significantly with endogenous depressions. A statistical test of the hypothesis that the data were consistent with there being only one clinical group was disproved. As a result of the work of Kiloh and Garside, the fact that certain symptoms tend to hang together clearly appears to be a mathematical certainty, but whether this has any biological meaning is an entirely different matter. Thus, one patient might present a number of cardiac symptoms (dilatation of the heart, cardiac insufficiency, systolic murmurs) because of an endocardial lesion. Another patient might present a number of symptoms (depression, delirium, headache, fits, delusions) referable to the central nervous system (CNS). In both cases the site of the lesion would determine the cluster of symptoms. However, because of advances in laboratory medicine and knowledge of the particular pathophysiology of the disease both cases cited above might be the result of the same illness, namely, lupus erythematosus, in which 40-59% of patients have cardiac involvement and 20-39% of patients have CNS lesions. Unfortunately, there are as yet no clear-cut pathological and laboratory findings for affective disorders and, consequently, it is not possible to say whether the presence of two separate clusters means that two separate diseases should be considered.
KeywordsAffective Disorder Psychiatric Illness Morbid Risk Affective Illness Affected Parent
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- 4.Winokur, G., and Pitts, F.N., Jr.: Affective disorder: I. I. reactive depression an entity?, J. Nerv. Ment. Dis. 138: 541–547, 1964.Google Scholar
- 5.Winokur, G., and Pitts, F. N., Jr.: Affective disorder: V. The diagnostic validity of depressive reactions, Psychiat. Quart. 39: 727–728, 1965.Google Scholar
- 6.Hudgens, R., Morrison, J. R., and Barche, R.: Life Events and the Onset of Primary Affective Disorders: A Study of 40 Hospitalized Patients and 40 Controls, Arch. Gen. Psychiat. (in press).Google Scholar
- 9.Hanna, B. L.: Genetic studies of family units, in Neel, J.O., Shaw, M.W., and Schull, W. J. (editors): Genetics and the Epidemiology of Chronic Diseases, U.S. Department of Health, Education and Welfare, Washington, 1965.Google Scholar
- 11.Kallman, F.: Genetic principles in manic-depressive psychosis, in Zubin, J., and Hoch, P. (editors): Depression, Proc. Amer. Psychopath. Assn., Grime and Stratton, New York, 1954.Google Scholar
- 12.Effinger, L., Laane, C. L., and Langfeldt, G.: The prognostic value of the clinical picture and the therapeutic value of physical treatment in schizophrenia and schizophreniform states, Acta Psychiat. Et. Neurol. Scand. 33: 33–53, 1958.Google Scholar
- 14.Cohen, M., and White, P.: Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome), Assn, Res. Nerv. and Ment. Dis. Proc. 29: 832, 1950.Google Scholar
- 15.Winokur, G., and Holemon, E.: Chronic anxiety neurosis: Clinical and sexual aspects, Acta Psychiat. Scand. 39: 384–412, 1963.Google Scholar
- 17.Perley, M., and Guze, S. B.: Hysteria: The stability and usefulness of clinical criteria, New Engl. J. Med. 226: 421–426, 1962.Google Scholar
- 19.Stenstedt, A.: A study in manic-depressive psychosis, Acta. Psychiat. Neurol. Scand. Suppl. 97, 1952.Google Scholar
- 20.Hill, A. Bradford: Principles of Medical Statistics, Oxford University Press, New York, 1961.Google Scholar