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Melancholia: A Disorder of Movement and Mood
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  • 9 b/w illus. 15 tables
  • Page extent: 0 pages

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 (ISBN-13: 9781139243544)

It has long been accepted that depressive disorders comprise a biologically-based type, the so-called 'endogenous' or 'melancholic' depression, and a residual set of depressive conditions resulting from social factors. The difficulty has been in distinguishing the melancholic type of depression on the basis of clinical features. This book describes the development of a behavioral sign-based approach, the CORE system, and demonstrates its superiority to previous symptom-based diagnostic systems for depression. The authors suggest that the psychomotor signs elicited may indicate the likely pathogenesis of melancholic depression, involving the basal ganglia and connections to the frontal cortex. This is therefore a challenging new account of the classification and neurobiology of depression, that is certain to interest all clinicians involved in the evaluation or treatment of such patients. The CORE measure itself is incorporated as an appendix.

• Describes a new diagnostic system for the most severe forms of depression • Contains important new ideas on the pathogenesis and treatment of depression • Parker is a well-known internationally for his research and previous books


Introduction; Classification and research: Historical and theoretical aspects; 1. Issues in classification: Part I. Some Historical Aspects: 2. Issues in classification: Part II. Classifying Melancholia: 3. Issues in classification; Part III. Utilizing Behavioral Constructs in Melancholia Research: 4. Issues in classification: Part IV. Some Statistical Aspects: Development and Validation of a Measure of Psychomotor Retardation as a Marker of Melancholia: 5. Psychomotor change as a feature of depressive disorders: historical overview and current assessment strategies; 6. Development and structure of the CORE system; 7. Reliability of the CORE measure; 8. Validity of the CORE: Part I. A Neuroendocrinological Strategy: 9. Validity of the CORE: Part II. Neuropsychological Tests: 10. Validity of the CORE; Part III. Outcome and Treatment Prediction: 11. Phenotypic expression of melancholia contrasted for those with bipolar and unipolar illness courses; 12. Psychotic depression: clinical definition, status and the relevance of psychomotor disturbance to its definition; 13. A clinical algorithm for defining melancholia: comparison with other sub-typing measures; 14. Rating the CORE: a user's guide; The Neurobiology of Melancholia: 15. Melancholia as a neurological disorder; 16. Melancholia and the aging brain; 17. Magnetic resonance imaging in primary and secondary depression; 18. Functional neuroimaging in affective disorders; 19. Summary and conclusions; Appendix; The CORE measure: procedural recommendations and rating guidelines; Bibliography.


'… a valuable synopsis of the work of one of Australia's leading psychiatric research groups … essential for anyone using the CORE in research … It also provides a stimulating and critical overview of the biological aspects of melancholia … a valuable addition to many depression researchers' bookshelves.' Pete Ellis, Australian Psychiatry

'This is an important book. It's exceptionally well written.' Conor Duggan


Marie-Paule Austin, Philip Boyce, Henry Brodaty, Heather Brotchie, Kerrie Eyers, Dusan Hadzi-Pavlovic, Catherine Hickie, Ian Hickie, Catherine Mason, Philip Mitchell, Gordon Parker, Elizabeth Scott, Ayse Sengoz, Kay Wilhelm

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