Syndromes and Themes of Psychotic Depression

This study developed from our original interest in exploring the possible existence of separate syndromes or types of depressive illness. We made the assumption that not all depressives are depressed about the same thing, and that they differ in regard to their primary values, psychodynamics, and prevailing dynamic themes. If this were so, it would then be useful to define and isolate types or subtypes of depression, and to consider what meaningful implications this classification would have for questions of prognosis, treatment, and for the understanding of the individual patient. Although many clinicians have had the impression that there are distinct types of depressives, there has been relatively little progress over the years in systematically refining the vague global concept of the abnormal state of depression. The classic psychoanalytic theory of depression expounded by Freud and Abrahams is based on consideration of ambivalence, aggressive