The facets of melancholia

W Coryell

doi:10.1111/j.1600-0447.2007.00960.x

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Journal article

Peer reviewed

The facets of melancholia

W Coryell

Acta psychiatrica Scandinavica. Supplementum, Vol.115(433), pp.31-36

2007

DOI: 10.1111/j.1600-0447.2007.00960.x

PMID: 17280568

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Abstract

To clarify the role of 'melancholia' in psychiatric nomenclature. Most clinicians and researchers are convinced that the syndrome currently termed major depressive disorder encompasses multiple subgroups that differ meaningfully in phenomenology, natural history, treatment response, and pathophysiology. Delusional depression and melancholia have attracted the most empirical work, but efforts to define the latter condition have declined in recent years following a number of failures to show the validity of the melancholic/nonmelancholic distinction. Review of experience. Beyond the DSM-IV symptom profile, melancholia has been associated with greater overall severity, a low likelihood of placebo response, an episodic course, a family history of depression without alcoholism, a relatively healthy personality, and hypothalamic-pituitary-adrenal axis hyperactivity. Evidence for the validity of the melancholia concept lies in the fact that the presence of each of these characteristics has been shown to increase the likelihood of one or more of the others. A diagnosis of melancholia may eventually prove valuable in treatment selection, but the necessary evidence will not be forthcoming until a widely accepted definition exists that is both inherently valid and that can be applied consistently across research sites.

Severity of Illness Index

Diagnosis, Differential

Diagnostic and Statistical Manual of Mental Disorders

Prevalence

Humans

Life Change Events

Suicide, Attempted - statistics & numerical data

Depressive Disorder - diagnosis

Alcoholism - epidemiology

Neurotic Disorders - psychology

Neurotic Disorders - epidemiology

Alcoholism - genetics

Personality Disorders - psychology

Depressive Disorder - epidemiology

Depressive Disorder - psychology

Alcoholism - psychology

Personality Disorders - epidemiology

Details

Title: Subtitle: The facets of melancholia
Creators: W Coryell - Psychiatry Research, University of Iowa College of Medicine, Iowa City 52242-1000, USA. william-coryell@uiowa.edu
Resource Type: Journal article
Publication Details: Acta psychiatrica Scandinavica. Supplementum, Vol.115(433), pp.31-36
Publisher: Denmark
DOI: 10.1111/j.1600-0447.2007.00960.x
PMID: 17280568
ISSN: 0065-1591
eISSN: 1600-5473
Language: English
Date published: 2007
Academic Unit: Psychiatry
Record Identifier: 9984003983702771

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