Abstract
A total of 130 cases that fulfilled the diagnostic criteria of major depressive episode by DSM-III (examined at the our outpatient clinic) was divided into a group with quick recovery (93 cases, total scores of DRS-S78reduced to 20 points within 8 weeks), and a protracted group (37 cases, total scores reduced to less than 20 points in more than 8 weeks) . DRS-S78is a depression inventory, revised in 1978 of the Showa University System. The possibility (if any) of protracting prospect, protracting factors, and background factors was reviewed. There was no significant difference between the two groups in total scores at the first examination. However, after 1 or 2 weeks, the total scores of the group with quick recovery were significantly lower, whereas there was no significant decrease in the total scores of the protracted group after 2 weeks. Thereafter, no tendency of the total scores to decrease was observed. The two groups were compared with reference to distribution of the various clinical factors: type, sex, heredity, premorbid personality, age at first onset and at this onset, period up to the time of receiving an examination after this onset, psychosocial stressors, and suicide. As a result, the incidence of manic-depressive psychosis in first degree relatives (parents, siblings, children) and the rate of Typus melancholicus or immodithymic character were significantly high in the protracted group. Also, the incidence of suicidal tendency, of which about 40% had first degree relatives with histories of manic-depressive psychosis, was significantly high in the protracted group. The protraction tendency might be due to biological factors… estimated to be the expression of heredity and resistance against antidepressants, so personality is estimated to be greatly involved, and protraction signs are reflected in the alterations of total scores after 1 or 2 weeks. Without a decrease in the total scores of cases of Typus melancholicus or immodithymic character after 1-2 weeks, there is a protraction possibility, so it is important to make a therapeutic plan taking into consideration the danger of suicide.
