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Defining Melancholia: Properties of a Refined Sign-Based Measure

Published online by Cambridge University Press:  02 January 2018

Gordon Parker ,
Dusan Hadzi-Pavlovic ,
Kay Wilhelm ,
Ian Hickie ,
Henry Brodaty ,
Philip Boyce ,
Philip Mitchell  and
Kerrie Eyers
Gordon Parker*
Affiliation:
University of New South Wales
Dusan Hadzi-Pavlovic
Affiliation:
Division of Psychiatry, Prince Henry Hospital
Kay Wilhelm
Affiliation:
Prince Henry Hospital
Ian Hickie
Affiliation:
University of New South Wales
Henry Brodaty
Affiliation:
University of New South Wales
Philip Boyce
Affiliation:
University of Sydney
Philip Mitchell
Affiliation:
University of New South Wales
Kerrie Eyers
Affiliation:
Prince Henry Hospital
*
∗Psychiatry Unit, Prince of Wales Hospital, Randwick 2031, Australia
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Abstract

We hypothesised that psychomotor disturbance is specific to the melancholic subtype of depression and capable of defining melancholia more precisely than symptom-based criteria sets. We studied 413 depressed patients, and examined the utility of a refined, operationally driven set of clinician-rated signs, principally against a set of historically accepted symptoms of endogeneity. We specified items defining psychomotor disturbance generally as well as those weighted either to agitation or to retardation. We demonstrated the system's capacity to differentiate ‘melancholic’ and ‘non-melancholic’ depression (and the comparable success of DSM–III–R and Newcastle criteria systems) by reference to several patient, illness and treatment response variables, to an independent measure of psychomotor disturbance (reaction time) and to a biological marker (the dexamethasone suppression test).

Type
Peer Review
Information
The British Journal of Psychiatry , Volume 164 , Issue 3 , March 1994 , pp. 316 - 326
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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