The Nosology of Depression: The Endogenous-Reactive Concept

Abstract

Controversies surrounding the distinctions between endogenous and reactive types have characterized the literature on depression. Reviewing seven pertinent factor analytic studies, these authors found sufficient consensus to support the independence of the endogenous and reactive factors. It is suggested, however, that these factors may not represent two etiologically distinct types of depression. The endogenous factor may reflect a "classical" depressive syndrome, whereas the reactive factor may reflect a psychiatric disorder in which depression is only one symptom "contaminated" by other nondepressive clinical features.

Long-Term Drug Therapy in Affective Disorders

“…The profile of scores on 3 factors differ among the institutions. Factor I is a general severity factor; factor II is a bipolar factor, similar in content to the endogenous-reactive con tinuum observed in other factor analytical studies (Mendels and Cochran, 1968); factor III is more difficult to define, but seems to be an anxiety-depressive mood factor. Comparing the profiles of scores from patients at the different institu tions, it is apparent that there are qualitative differences in the types of depres- sion seen.…”

The Concept of Mental Pain

“…[30]] have emphasized that the patients with endogenous depression may manifest a ‘distinct quality’ of dysphoric mood. This feature was recognized by early clinicians [31,32] and was described as a uniquely aversive, anguished, or uncomfortable experience that is characterized by painful tension and torment [31].…”

Major depression: revisiting the concept and diagnosis

“…In the 1960s the division of depression into psychotic/neurotic and endogenous/reactive (exogenous) categories was at the centre of the contro versy (Mendels 1968). Psychotic and endogenous were often considered synonymous, as were neurotic and reactive.…”