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A Family Study Approach

Nancy C. Andreasen, MD, PhD; William Scheftner, MD; Theodore Reich, MD; Robert M. A. Hirschfeld, MD; Jean Endicott, PhD; Martin B. Keller, MD

Arch Gen Psychiatry. 1986;43(3):246-251.

Abstract
• Depressive illnesses are subdivided into endogenous and nonendogenous types in psychiatry throughout the world. We used one method of validating this nosologic subdivision: the determination of the extent to which the disorder is familial. Rates of depression were examined in 2,942 first-degree relatives of 566 individuals diagnosed as having unipolar major depressive disorder. Because no single definition of endogenous depression is universally accepted, four different methods for defining endogenous depression were compared: the Newcastle Scale, the Research Diagnostic Criteria, DSM-III, and the definition of "autonomous depression" proposed by investigators at Yale University (New Haven, Conn). In general, no matter which definition was used, the relatives of the patients with endogenous illness did not have higher rates of depressive illness than those of the nonendogenous group. The Newcastle Scale was the most sensitive in picking up familial transmission of recurrent unipolar depression. The results of this investigation suggest that longitudinal approaches should be added to cross-sectional approaches for the best definition of endogenous depression.

Author Affiliations
From the National Institute of Mental Health-Clinical Research Branch Collaborative Program on the Psychobiology of Depression—Clinical Studies, Washington, DC (Drs Andreasen, Scheftner, Reich, Hirschfeld, Endicott, and Keller); Department of Psychiatry, University of Iowa, Iowa City (Dr Andreasen); Collaborative Study Group, Rush Presbyterian-St Luke's Medical Center, Chicago (Dr Scheftner); Department of Psychiatry, Washington University Medical Center, St Louis (Dr Reich); Clinical Research Branch, National Institute of Mental Health, Washington, DC (Dr Hirschfeld); Evaluation Section, Biometrics Research Division, New York State Psychiatric Institute, New York (Dr Endicott); and Lindemann Mental Health Center, Boston (Dr Keller).

Footnotes
Accepted for publication Aug 19, 1985.

Reprint requests to Department of Psychiatry, University of Iowa, 500 Newton Rd, Iowa City, IA 52242 (Dr Andreasen).

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