Psychosocial risk factors distinguishing melancholic and nonmelancholic depression: a comparison of six systems

Psychiatry Res. 1991 Dec;39(3):211-26. doi: 10.1016/0165-1781(91)90089-8.

Abstract

We examined six systems or scales designed to distinguish melancholia from residual nonmelancholic depressive disorders in a sample of 305 patients. A count of the number of significant psychosocial risk factors showed that a clinical diagnosis was the most differentiating (19 significant risk factors), followed by the Newcastle index (13), DSM-III (10), and the CORE system (10)--the last essentially assessing psychomotor change; Research Diagnostic Criteria (RDC) (7) and an endogeneity symptom scale (2) were the least differentiating. A subsample of "composite melancholics" was derived, comprising 138 who met "melancholia" criteria for DSM-III, RDC, and CORE, and they were contrasted with residual depressives. The composite melancholics were older, had had a briefer depressive episode, and differed significantly on 12 risk factors, essentially being less likely to report deprivational experiences such as deficient parenting and dysfunctional marital relationships. We suggest that such a risk factor strategy is of potential use in refining the clinical definition of melancholia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bipolar Disorder / classification
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / psychology
  • Depressive Disorder / classification
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Diagnosis, Differential
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Middle Aged
  • Personality Development
  • Personality Inventory / statistics & numerical data
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics
  • Social Environment*
  • Social Support