EVIDENCE FOR THE EXISTENCE OF MAJOR DEPRESSION WITH AND WITHOUT ANXIETY FEATURES

Several studies have reported on comorbidity between depression and an xiety. The present study investigates the occurrence of anxiety sympto ms during an episode of unipolar depression. The authors administered the 15-item Rating Scale for Anxiety States of Hamilton (HAM-A) to 73 depressed inpatients categorized according to DSM-III criteria into mi nor (300.40,309.00), major depression without (296.X2) and with (296.X 3) melancholia. Principal-component (PC) analysis revealed three inter pretable PCs: a somatic anxiety, a depression-anxiety overlap, and an anxious mood-behavior factor. Subjects with major depression showed si gnificantly higher ratings on total HAM-A score, the three above PCs, and on all HAM-A items (except general somatic muscular and genitourin ary symptoms) than subjects with minor depression. A cluster analysis generated two stable, qualitatively distinct clusters: i.e. one with s evere anxiety and one with no or minimal anxiety; the six most discrim inating symptoms were: tension, behavior at interview (general or phys iological), respiratory, genitourinary and autonomic symptoms. Up to 9 5.4% of patients allocated to the severe anxiety cluster were major de pressives. The results suggest that major depression may be divided in to two qualitatively distinct classes, i.e. major depression with and without anxiety features.