Melancholia: Does This Ancient Concept Have Contemporary Utility?

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dc.contributor.authorSani, Gabriele
dc.contributor.authorTondo, Leonardo
dc.contributor.authorUndurraga, Juan
dc.contributor.authorVázquez, Gustavo H.
dc.contributor.authorSalvatore, Paola
dc.contributor.authorBaldessarini, Ross J.
dc.date.accessioned2021-08-17T21:41:36Z
dc.date.available2021-08-17T21:41:36Z
dc.date.issued2020
dc.description.abstractMany efforts have been made to develop coherent and clinically useful categories of depressive illness, especially to facilitate prediction of morbidity and guide treatment-response. They include proposals to resurrect the ancient concept of melancholia, a form of severe depression with particular symptomatic and proposed psychobiological characteristics. However, modern research is inconsistent in supporting differences between melancholic and nonmelancholic depression. In our recent study of over 3200 patient-subjects with DSM-5 major depressive episodes with/without melancholic characteristics, and matched for illness severity, prevalence of melancholic features was 35.2% with remarkably few clinical differences between melancholic and nonmelancholic subjects. Also, our systematic review of trials comparing melancholic and nonmelancholic subjects found little difference in responses to antidepressant treatments. These findings indicate that the concept of melancholia may have limited value for clinical prediction and treatment-selection. Overlap of symptoms in melancholic and nonmelancholic depression, based on DSM criteria, may limit distinction of melancholia; alternative definitions can be sought, and psychomotor retardation is a particularly strong differentiating feature. For now, however, melancholia seems best considered a state-dependent depression-type strongly associated with greater symptomatic severity, rather than a distinct syndrome. Its current status as a depression-type specifier seems appropriate, and it is a logical target for genetic and other biomedical studies.es
dc.identifier.citationInternational Review of Psychiatry, 2020es
dc.identifier.urihttps://dx.doi.org/10.1080/09540261.2019.1708708es
dc.identifier.urihttp://hdl.handle.net/11447/4351
dc.language.isoenes
dc.subjectBipolar disorderes
dc.subjectDSM-5es
dc.subjectMajor depressiones
dc.subjectMelancholiaes
dc.subjectTreatmentes
dc.titleMelancholia: Does This Ancient Concept Have Contemporary Utility?es
dc.typeArticlees

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