Psychopharmacology and the Classification of Functional Psychoses 

By Thomas A. Ban and Bertalan Pethö

Four-Dimensional Classification

Affective Psychoses

Melancholia and Depressions

         Of the two cross-sectional psychopathologic syndromes encountered in manic-depressive psychosis, depression is the more frequent. It has been estimated that 100 million people worldwide suffer from a recognizable depression (Ban et al., 1981). A survey carried out from 1967 to 1976 in a community in the United States revealed that 6.8 percent of the respondents were experiencing depression at the time of the survey (period prevalence) and 26.7 (one of four respondents) had experienced symptoms of depression earlier in their lives (lifetime prevalence) (Weissman and Klerman, 1978; Weissman and Myers, 1978a,b). However, not all persons who have experienced depression suffer from a clinically verifiable depressive illness. If those cases that are not depressive illnesses are excluded, the prevalence figures are considerably lower.

         The incidence of affective illness in the general population is estimated to be approximately 2% (i.e., 1 of 50) with a slightly higher incidence in females (2.5%) than.in males (1.8%). Among the relatives of unipolar and bipolar patients, however, the risk for all mood disorders jumps to between 10 to 20 times the general population rate (Tsuang and Vandermey, 1980). Accordingly, Winokur and Clayton (1967) found that the risk of brothers and sisters of a person with mood disorder rises from 12% if neither parent is ill, through 26% if one parent is ill, to 43% if both parents are ill. Although the mode of inheritance remains hidden the significant increase in the rate of occurrence of affective disorder among the biological relatives of patients indicate that biological-genetic factors play an important role in the etiology of these illnesses.