Institute of Psychiatry, University of Milan, School of Medicine, 20122 Milan, Italy
Marked anxiety symptoms often accompany episodes of major depression (3,10,16,17,20), but the way in which such symptoms can be employed for sub-classifying affective disorders is still an unresolved issue. It has been suggested that anxiety symptoms may mark the more severe forms of depressive disorders (9). In fact, clinical ratings of anxiety and depression have been positively cor­related in patients with major affective disorders (4,8). Furthermore, a parallel increase in the number of DSM-III (1) defined symptoms of anxiety and depres­sion has been found in patients seen in primary care settings (9). If it is actually true that the more severe the major depression, the greater the probability of the presence of concomitant anxiety, depression with anxiety symptoms could be expected to be associated with the presence of other severity indices. One of the most promising of these recently has been shown to be cerebral ventricular dilation as assessed by Computed Tomography (CT). Ventricular enlargement has been found among the most severely and socially impaired depressives, those presenting characteristics such as delusional symp­toms (11,23,25,26), suicidal tendencies (11,15), frequent hospitalizations (18,19), persisting unemployment (18), and, at least in the elderly, high mortality rates (13). As part of a comprehensive effort to improve our knowledge of major depres­sion with anxious symptomatology (Sacchetti et al., this volume), we undertook a study to determine whether anxious and nonanxious major depressives have different brain morphological characteristics.

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