Guilt and conscience in major depressive disorders

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.