A clinical study on mental state at the time of recovery from depressive states. – Comparing mood disorders and adjustment disorders – *
［Purpose］ This study compares the mental state at the time of recovery from the depressive state of mood disorders and from that of adjustment disorders, and examines the differences anew. ［Object］ The patients were referred to the Department of Psychiatry at Kawasaki Medical School Hospital for depressive states and were diagnosed with mood disorders or adjustment disorders based on the Diagnostic Criteria of Mental Disorders（DSM-Ⅳ-TR）of the American Psychiatric Association. The total number of patients who underwent treatment and recovered was 135. ［Method］ Psychiatrists evaluated the objective mental state of the patients using the Hamilton Rating Scale for Depression（HAM-D）and the patients filled in a questionnaire consisting of the Beck Depression Inventory（BDI）and the Symptom Checklist-90-Revised（SCL-90-R）to evaluate their subjective mental state. Mental states, subjective and objective evaluation, a sex differences and age were examined by BDI and SCL-90-R. ［Result］ The SCL-90-R scores for adjustment disorders were significantly higher than those for bipolar disorders, single episode and recurrent major depressive disorders. The BDI scores for adjustment disorders were significantly higher than those for bipolar disorders, single episodes and recurrent major depressive disorders in that order. The profiles of subscales of the SCL-90-R and each disorder group were similar, and showed high scores on the obsessive-compulsive subscale and the depression subscale. ［Consideration］ Although the SCL-90-R indicates mental state and the degree of serious mental illness broadly, it tends to reflect the symptoms of neurotic disorders, more than those of other disorders. It has been commonly accepted that neurotic disorders are strongly influenced by psychogenic factors. The results SCL-90-R showed that the normal group scored from highest to lowest for adjustment disorders, recurrent major depressive disorders, single episodes, and bipolar disorders respectively. I think that recovering patients report broad psychiatric symptoms objectively or suffer from psychiatric symptoms subjectively as the above findings indicate. In addition, I think that the tendency in adjustment disorders for subjective evaluation（BDI）to be bad is more remarkable than objective evaluation（HAM-D）, and it may be that patients with adjustment disorders are too conscious of the depressive state of adjustment disorders they may make too low a self evaluation. It is considered that, as has been suggested, that the fact that obsessive-compulsive subscale and depression subscale show the highest values means the close relation between obsessive-compulsive subscale and depression. Although the SCL-90-R scores in each disease group are differed, the profiles of subscales of adjustment disorders and mood disorders are similar. It should be further considered whether adjustment disorders which present with a depressive can be regarded as part of the broad spectrum of mood disorders. (Accepted on September １，2005)
