The distinction of primary and secondary affective disorders. Clinical implications

We studied a sample of 26 primary depressives and 18 secondary depressives for a number of demographic, family history, and clinical variables and prospectively followed them over one hospitalisation to assess short-term differences in outcome. The Hamilton rating scale for depression and the Zung self-rating depression scale were administered at admission and discharge. While both groups received similar treatments, the primary depressives exhibited a statistically significantly greater degree of recovery than the secondary depressives as measured by these scales. The secondary depressives had more prior suicide attempts (if psychiatrically or medically non-serious attempts are included), a longer duration of current episode of depression and a higher proportion of relatives with alcoholism than the primary depressives.