Primary and secondary affective disorder: Part III. Longitudinal differences in depression symptoms

Depressed inpatients (29 primary and 31 secondary) were blindly rated at several time points on 137 depressive symptoms. Of the 7 high-frequency symptoms or symptom clusters analyzed, significantly greater symptom persistence was seen for secondary depressives on low mood, pessimism, change in usual interests, and suicidal ideation. Day-to-day variability in symptoms did not differ between groups. Scalability of symptoms (Guttman scales) was acceptable for primary but not secondary depressives. Suicidal ideation tended to be the first symptom to remit in primary depression but persisted in the secondary group, even after remission of the most severe symptom. Implications for treatment are discussed.