Familial subtypes of depression: a clinical view

The clinical workup of 238 unipolar depressives were subdivided according to immediate family history. Pure depressives (with only depression in the family) typically have an illness involving more endogenous features and chronicity. Depression spectrum patients (with only alcoholism or sociopathy in first-degree relatives) have the mildest illness. Sporadic depression (with a negative family history) is associated with an intermediate severity. Premorbid unstable personality characteristics are more common to the spectrum patients. Sporadic patients have the least personality difficulties. While these differences are definite, they are not large enough to justify separation of unipolar depression into subsyndromes dependent on symptom differences. Rather, family history seems to exert its effect most strongly on the distinctive premorbid personality characteristics of the 3 groups.