Sub-grouping non-melancholic major depression using both clinical and aetiological features

Objective: In previous papers we have considered the extent to which two co ntrasting analytic approaches, examining reported clinical symptom variable s alone and aetiological variables alone, assist definition of subgroups of non-melancholic major depression. Here, we address the same objective but combine both sets of variables, and contrast the combined solution with eac h of the contributing ones. Method: We study a sample of 185 subjects with a putative non-melancholic m ajor depressive disorder, with analyses involving 13 aetiological and 38 sy mptom variables, Results: A four-class subgrouping was derived by use of a cluster analytic technique, with 'neurotic depression', non-anxious 'depressed', 'situationa l' and 'residual' groups. The largest group comprised 'neurotic depression' subjects, with characteristics compatible with a spectrum disorder encompa ssing both clinical features as well as an underlying temperament and perso nality style marked by anxiety. Conclusions: Comparative advantages and properties of the three differing a nalytic approaches to defining 'meaningful' non-melancholic major depressiv e subgroupings are considered. As a 'neurotic depressive' class has been co nsistently identified across those three approaches, but with quite varying numbers of subjects circumscribed, it is clearly a 'fuzzy' entity which ma y benefit from a dimensional approach to its measurement. As many of the no n-melancholic groupings appear secondary to a substantive predisposing fact or such as anxiety or disordered personality functioning, the clinical impo rtance and treatment utility in identifying and circumscribing such classes are clearly supported.