This research was supported in part by the C.N.R. grant no. 86.01935.56. The authors thank Dr. June Shmelzer La Rosa for her precious assistance in revising the manuscript.

Table 1 presents the retabulated data from all three studies. It is important to note that the rates of MDD (primary plus secondary) among relatives of probands with MDD without anxiety (MDD), panic disorder with or without depression (PD ± MDD), and agoraphobia with or without depression (Ag/PD ± MDD) were not significantly different from each other and all were significantly greater than the rate observed among relatives of controls (Table 2). The rate of MDD among relatives of MDD probands with chronologically secondary panic disorder (MDD + PD) was higher than the rates of MDD among relatives of other types of probands. The rate of MDD among relatives of panic disorder and agoraphobic probands could be lower because of the fact that it represents an average rate from families of panic disorder and/or agoraphobic probands with and without depression. It is important to note that the rates of MDD among relatives of MDD probands with or without panic (MDD ± PD) is not significantly elevated when compared to the rates of MDD among relatives of PD ± MDD and Ag/ PD ± MDD probands. If the pattern is similar to that observed among relatives of MDD probands, then there could be a significantly elevated rate among rel­atives of anxious probands with chronologically secondary depression when compared to the rates among relatives of anxious-only probands. Unfortunately, the published data do not allow the separation of anxious probands into those groups. Nevertheless, these results demonstrate that when overall rates of diagnoses
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All patients hospitalized at the Department of Psychiatry, Umea University, during the years 1960-1963 with the clinical diagnosis of neurotic-reactive depression were reevaluated and followed for 10 years. At the reevaluation of the records, it was found that the clinical diagnosis neurotic-reactive depression was used in a very imprecise way. Only 83 of the 146 patients with the clinical diagnosis of neurotic-reactive depression fulfilled our research criteria for neu­rotic-reactive depression (Table 2). When the 83 patients fulfilling our research criteria were followed over 10 years, the diagnosis was only changed in 2 (4%) of the patients (Table 3). Our results are in line with the findings of Rasmussen et al. (15); in their study only 2 of 23 patients with neurotic-reactive depression developed an affective psychosis during a 15-year follow-up period. However, the results are contradictory to the results obtained by Akiskal et al. (1). In their study 40% of the patients with neurotic-reactive depression developed a unipolar or bipolar affective disorder during a 3 to 4-year follow-up period. The discrepancy is probably owing to the differences in the diagnostic criteria used. If we had accepted the clinical diagnosis of neurotic-reactive depression and followed the whole group, our results would have been much more similar to the ones achieved by Akiskal et al. (1). However,
if our diagnostic criteria are followed strictly, we seem to be able to delineate a subgroup that at least is clearly distinct from unipolar and bipolar affective dis­orders. (more…)

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