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Situational and Neurotic-Reactive Depression

Richard M. Glass, MD
Arch Gen Psychiatry. 1985;42(11):1126-1127. doi:10.1001/archpsyc.1985.01790340110015.
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One of the critical tasks facing the clinical research "consumer" is the appropriate translation of the meaning of research results (usually based on averages or proportions from groups of patients) for the clinical encounter with an individual patient. As in literature, things sometimes get lost or distorted in the translation. Two articles in this issue of the Archives present research findings on the classification of depressive illnesses and provide a good illustration of this challenge for clinical readers.

Winokur1 reports that a family history of alcoholism is a validating factor for a diagnosis of "neurotic-reactive" depression, a type of unipolar depression for which he proposes specific diagnostic criteria largely based on a history of a stormy life-style and preexisting personality problems. Hirschfeld et al2 report that a group of patients with "situational" major depression, defined by the presence of an apparent precipitant for the illness episode,3 showed


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