Clinicai Features of Depressive States with Pervasive Developmental Disorders *
We investigated the incidence of comorbid pervasive developmental disorders (PDD) in patients with depressive states, in additions to observing the characteristics of clinical manifestations in those patients. The subjects of this study were 64 patients, between 18 and 49 years of age, with a diagnosis of mood disorder or adjustment disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-Ⅳ-TR), and concomitant mild to moderate depression, as determined by the Hamilton Rating Scale for Depression (HAM-D). Mental symptoms were evaluated using the HAM-D, the Beck Depression Inventory (BDI), and the Symptom Checklist-90-Revised (SCL-90-R).PDD were evaluated from developmental histories obtained from caregivers and self-completed questionnaires by the participants. The following results were obtained. 1) Of the 64 subjects, 23 were diagnosed with PDD (35.9%). 2) Overall HAM-D score showed no significant effect for either the PDD group or non- PDD group, but overall score for BDI was significantly higher in the PDD group (31.3±11) than in the non-PDD group (24±9.9). 3) PDD group scores were significantly higher for the four BDI items of Sadness, Crying, Worthlessness and a Decreased appetite. 4) The SCL-90-R scores in the PDD group scores were significantly higher for Obsessive-Compulsive, Interpersonal Sensitivity and Paranoid ideation. 5) In regard to the Autism-Spectrum Quotient Japanese Version, in the PDD group, patient scores were significantly higher than the family scores for Attention switching and Communication. These findings suggest that one characteristic of depression in the PDD group is that the score on the HAM-D, which is objectively evaluated by doctors, shows no significant effect, whereas the score on the BDI, which is subjectively evaluated by patients, is high. It is possible that patients have difficulty comparing their internal experiences to others, making comparisons over time, or having an “all or nothing” way of seeing things. In addition, even for similar degrees of depression, some patients may experience greater distress. Since individuals in the PDD group have social and communication disorders, they may easily accumulate negative experiences, such as being shunned by others of the same age, or being alone, and this could then be the reason for the increase in scores for Worthlessness on the BDI and Interpersonal Sensitivity or Paranoid ideation on the SCL-90-R. (Accepted on September 25, 2012)
