DOUBLE DEPRESSION - A DISTINCTIVE SUBTYPE OF UNIPOLAR DEPRESSION

Whether depression is a single disease that varies from mild to severe , with varying episode durations and difficult course patterns, or whe ther it is an umbrella diagnosis representing depressive subtypes with different psychological and biological characteristics has been debat ed by clinicians and researchers for many years. However, most scienti sts now agree that understanding the heterogeneous subtypes of depress ion allows for greater accuracy in describing and differentiating pati ents suffering from depression and, therefore, greater precision in de scribing the most efficacious treatment plan. This article will focus on the distinctions between unipolar major depression, double depressi on and dysthymia, and will review the history of the DSM classificatio ns for these ''subtypes'' of depression. The paper will also discuss t he fact that despite a lack of scientific validation of the subtypes o f major depressive disorder, clinicians and researchers continue to su bclassify major depression and, particularly, for the purpose of testi ng the efficacy of new psychopharmocologic and psychosocial treatments . There continues to be a need for future research to more clearly est ablish the predictive value in terms of course, recovery, rates of rel apse and treatment in regard to distinguishing type of depression as w ell as to validate the current nosology. (C) 1997 Elsevier Science B.V .