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ANXIETY STATES AND DEPRESSIVE NEUROSES: ISSUES IN NOSOLOGICAL DISCRIMINATION

This article reviews current conceptions of the nosology of the neurotic affective disorders with particular emphasis on the controversy concerning the status of the anxiety states and depressive neuroses as distinct clinical syndromes. Empirical evidence in support of both the distinct-syndrome and unitary-syndrome positions is reviewed and related to current theoretical postures. Analysis suggests that the pivotal question does not center on whether distinctions can be made between the two conditions, but rather, whether differences observed are of a magnitude to be clinically significant. Five primary issues—all judged to have substantial nosological relevance—are examined specifically in terms of their influence on the classification of the affective neuroses. Conclusions point up the fact that the development of a definitive system of classification for these conditions represents a complex, multidetermined problem that will demand full utilization of the information and methodology available to contemporary clinical science.