THE ROLE OF PSYCHOSOCIAL AND BIOLOGICAL VARIABLES IN SEPARATING CHRONIC AND NON-CHRONIC MAJOR DEPRESSION AND EARLY-LATE-ONSET DYSTHYMIA

Psychosocial (sociodemographic characteristics, loss and separation an d family atmosphere in childhood, recent life events) and biological ( family history, DST, TRH-test) variables were investigated in 180 pati ents with Major Depression (MD) and Dysthymic Disorder (DD). The aim o f the study was to reveal certain differences between the chronic and non-chronic course of MD and the early- and late-onset subtypes of dys thymia. When comparing the two course patterns of MD, a higher rate of malignant tumours among first-degree relatives, a greater number of l ong-lasting stress situations before the index depressive episode, lon ger duration of the previous episodes, less frequent DST nonsuppressio n, and a blunted TSH response to TRH were found in patients with a chr onic course of MD. Several factors seem to influence the course patter n of MD, or else the chronic form represents a subgroup within MD. The late-onset dysthymics were mainly women with a low level of education , a lower suicidal tendency, normal suppression in DST, and a lack of blunted TSH responses to TRH administration during the period of doubl e depression. The early-onset dysthymics showed a higher number of per sons who had never married, who presented a more traumatic and frustra ting childhood background, and who had a higher rate of DST non-suppre ssors and blunted TSH responses after TRH administration during the pe riod of their double depression. Our data suggest that late-onset dyst hymia might be a biologically distinct subgroup of chronic depression.