The results of two studies on overt guilt in psychiatric patients in general and depressives in particular, involving 221 and 134 patients respectively, suggest that neurotic depressives as a group are guiltier than nondepressives. The results with psychotic depressives were less consistent; most measures employed did not show them as differing greatly from nondepressives, but some scattered evidence suggested that psychotic depressives may score higher than nondepressives on overt guilt. Overall, guilt was not intrinsic to all depressive disorders. While there was a relationship between psychiatric diagnosis and guilt, diagnosis was not a very strong factor. Guilt and negative self-images were strongly related. Depressive patients had lower selfimages than nondepressives. The results suggested that negative selfconcepts are a more striking feature of depressive, as opposed to nondepressive, patients than is guilt.
Harrow M, Amdur MJ. Guilt and Depressive Disorders. Arch Gen Psychiatry. 1971;25(3):240-246. doi:10.1001/archpsyc.1971.01750150048007