The current status of neurotic depression as a diagnostic category.

Abstract

Neurotic Depression was among the most commonly used psychiatric diagnoses until the introduction of DSM-III. Because of multiple criteria and meanings and the lack of diagnostic stability on follow-up, Neurotic Depression was not included as a category in DSM-III and will be omitted in ICD-10. This article reviews recent research on the validity of Neurotic Depression and its relationship to other types of depressive disorders. Empirical studies do not support the validity of this diagnosis. There is no unitary clinical description or phenomenological discrimination from other disorders, and limited supporting family study, laboratory investigation, or specific treatment response. Revised criteria for Neurotic Depression, derived from three recently conducted studies, need to be validated in prospective studies. Pending new research findings, the decision to omit Neurotic Depression from the classification of depressive disorders in DSM-III, DSM-III-R and in the draft of ICD-10 remains scientifically justified.