SEVERITY AS A KEY CONSTRUCT IN DEPRESSION

Mild, moderate, and severely depressed subgroups were operationally de fined in a sample of hospitalized patients clinically diagnosed as dep ressed. Women were overrepresented among the severely depressed patien ts, but no other demographic differences among subgroups were found. G eneralized anxiety and psychic disorganization were significantly more pronounced in patients who were severely depressed. Severely depresse d people also reported more role-performance impairments than did thos e who were less seriously depressed. Among women, a secondary diagnosi s of substance abuse was present significantly less often in the sever ely depressed. Based on self-reports at admission and 4 weeks later, m arked improvement was seen only among the moderately depressed. There was not a statistically significant symptom change in the mildly depre ssed group; for the severely depressed, the change over time was signi ficant but the patients remained highly symptomatic. The authors discu ss the importance of the construct of severity for clinical practice, hospital policy, and future research.