Outcome with desipramine therapy in subtypes of nonpsychotic major depression

A consecutive series of 42 outpatients with major depression were classified as having endogenous or nonendogenous depression according to RDC, primary or secondary depression according to the criteria of Feighner et al. (1972) and suppression or nonsuppression according to a dexamethasone suppression test. These groups were then compared according to outcome after an initial placebo phase and after 6 weeks of treatment with desipramine. Patients with secondary depression were somewhat more likely to respond to placebo and were significantly less likely to complete the entire course of treatment. The primary/secondary distinction but not the endogenous/nonendogenous distinction predicted clinical status after desipramine therapy. In accord with earlier reports, nonsuppressors faired better than suppressors though this difference did not reach statistical significance. Moreover, nonsuppressors tended to have outcomes which were more discrete as reflected in a bimodal distribution for final scores, in contrast, final scores for suppressors assumed a more unimodal distribution.