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Clinical and Sleep EEG Findings Separating 'Subaffective Dysthymias' From 'Character Spectrum Disorders'

Hagop S. Akiskal, MD; Ted L. Rosenthal, PhD; Radwan F. Haykal, MD; Helio Lemmi, MD; Renate H. Rosenthal, PhD; Alice Scott-Strauss, MSW

Arch Gen Psychiatry. 1980;37(7):777-783.

Abstract
• Early-onset characterological depressions are distinguished from late-onset chronic depressions that complicate the longterm course of unipolar and nonaffective illnesses. In turn, characterological depressions are divisible into at least two subtypes: (1) "Subaffective dysthymias" have even sex distribution, are often complicated by superimposed depressive episodes, rapid eye movement latency is shortened, and they tend to respond to tricyclics or lithium carbonate. In brief, they share many features of primary affective illness. (2) "Character spectrum disorders," by contrast, represent a heterogeneous mixture of personality disorders with inconstant depressive features, are more common in women, are often complicated by alcohol and drug abuse, and outcome tends to be unfavorable.

Author Affiliations
From the Mood Clinic and Affective Disorders Program, Department of Psychiatry (Drs Akiskal and T. L. Rosenthal, and Ms Scott-Strauss), Department of Pharmacology (Dr Akiskal), Department of Neurology (Dr Lemmi), the Psychiatric Liaison Service (Dr R. H. Rosenthal), and the Affective Disorder Unit, Veterans Administration Hospital at the University of Tennessee Center for Health Sciences (Dr Haykal); the Sleep Disorder Center, Laboratory of Neurophysiology, Baptist Memorial Hospital (Drs Akiskal and Lemmi); the Mid-South Hospital (Dr T. L. Rosenthal); and the Mood Clinic, Northeast Mental Health Center (Dr Akiskal); Memphis.

Footnotes
Accepted for publication June 6, 1979.

Reprint requests to Mood Clinic, Department of Psychiatry, University of Tennessee, 42 N Dunlap St, Memphis, TN 38103 (Dr Akiskal).

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