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Sub-typing depression, III. Development of a clinical algorithm for melancholia and comparison with other diagnostic measures

Published online by Cambridge University Press:  09 July 2009

G. Parker*
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
D. Hadzi-Pavlovic
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
I. Hickie
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
H. Brodaty
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
P. Boyce
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
P. Mitchell
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
K. Wilhelm
Affiliation:
Mood Disorders Unit, Prince Henry Hospital and the School of Psychiatry, University of New South Wales, NSW, Australia
*
1Address for Correspondence: Professor Gordon Parker, Psychiatry Unit, Prince of Wales Hospital, Randwick, NSW 2031, Australia.

Synopsis

We describe the development of a clinical algorithm to differentiate melancholic from non-melancholic depression, using refined sets of ‘endogeneity’ symptoms together with clinician-rated CORE scores assessing psychomotor disturbance. Assignment by the empirically developed algorithm is contrasted with assignment by DSM-III-R and with several other melancholia subtyping indices. Both the numbers of ‘melancholies’ assigned by the several systems and their capacity to distinguish ‘melancholics’ on clinical, demographic and a biological index test (the DST) varied across the systems with the algorithm being as ‘successful’ as several systems that include inter-episode and treatment response variables. Analyses provide information on the criteria set developed for DSM-IV definition of ‘melancholia’.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

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