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Recognition and subtyping of atypical depression by French Practitioners

Published online by Cambridge University Press:  16 April 2020

P Boyer
Affiliation:
Inserm, Clinique des maladies mentales et de l'encéphale, 100, rue de la Santé, 75014Paris
Y Lecrubier
Affiliation:
Hôpital de la Salpêtrière, Pavillon Clérambault, 47 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
AJ Puech
Affiliation:
Hôpital de la Salpêtrière, Pavillon Clérambault, 47 boulevard de l'Hôpital, 75651 Paris Cedex 13, France
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Summary

A two-part survey of French General practitioners was carried out to determine attitudes and diagnostic criteria for definition of atypical depression, major depressive episodes, and anxiety disorder. Following a preliminary phase in which 90 physicians were interviewed, 500 general practitioners received detailed questionnaires based upon DSM III-R criteria, as well as supplementary questions based upon the Leibowitz and Akiskal criteria. Principal criteria analysis and regression analysis were carried out on the 280 analyzable files received. Results showed that anxiety disorders were primarily defined in terms of somatic criteria, and that there were a number of factors common to anxiety and depression. Minor depression was also defined primarily on the basis of somatic complaints, together with loss of energy and fatigue. Major depression was defined primarily by asthenia, apragmatism and loss of drive, together with less strongly weighted cognitive factors (sadness, Pessimism, inhibition, etc). From a dimensional standpoint, depression is defined as a “vital deficit”, with a failure to cope with social and environmental demands. It is interesting to note that the duration criterion was not considered to be of nosological relevance by the physicians, and was generally ignored in the definition of mental pathologies. The international subtyping of depressive disorders does not form part of the Practice of French practitioners, who prefer to retain the older, psychosocial models.

Type
Research Article
Copyright
Copyright © European Psychiatric Association 1993

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References

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