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Guilt and conscience in major depressive disorders
Am J Psychiatry 1983;140:839-844.
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Abstract

The authors propose definitions of guilt as a self-critical feeling state and of conscience as a set of standards, to permit independent assessment of their prevalence in a sample of 93 depressed, 29 schizophrenic, and 43 normal subjects. Patients with feelings of guilt tended to have a more severe conscience and lower self-esteem. While guilt is prominent in a moderate percentage of depressed patients, negative self-esteem may form one of the cornerstones for depressed patients of all types. The authors propose that the operational definition of psychoanalytic concepts such as guilt and conscience permits a valid and more rigorous test of clinical generalizations.

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Guilt and conscience in major depressive disorders. Am J Psychiatry 1983;140(7):839-44.