ABSTRACT
In this chapter we continue with the issue of symptom-formation factors and particularly their relation to the classic distinction between psychotic and neurotic depression. In collecting material for this chapter we used a traditional psychiatric diagnosis of psychotic and neurotic depression, relying on the clinical judgment of a psychiatric colleague at the Institute of Psychiatry who took into account criteria such as the presence of early morning waking and retardation, which are fairly generally accepted as distinguishing features of the two forms of depression. Since ‘psychotic’ and ‘neurotic’ symptoms can occur in both types of depression, a judgment has to be made on the basis of the total clinical picture rather than the presence of particular symptoms. For example, just over half the patients considered psychotic and just over a fifth of the neurotic patients had early morning waking. Using such an overall judgment, sixty-three patients were classified as psychotic and forty-nine as neurotic. (Two with some manic symptoms were excluded from this part of the analysis.)
