BACKGROUND: The purpose of this paper is to use demographic and clinical data from a large diverse group of outpatients diagnosed with non-psychotic major depression to investigate the validity of the DSM-IV concept of melancholic depression. METHODS: Baseline clinical and demographic data were collected on 1500 outpatients (1456 of whom melancholia could be determined) with non-psychotic major depressive disorder (MDD) participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Depressive symptom severity was assessed by clinical telephone interview using the 17-item Hamilton Rating Scale for Depression (HRS-D17) and the 30-item Inventory of Depressive Symptomatology (IDS-C30). The types and degrees of concurrent psychiatric symptoms were measured using a self report, the Psychiatric Diagnostic Screening Questionnaire (PDSQ), by recording the number of items relevant to each diagnostic category endorsed by study participants. RESULTS: Adjusting for severity of depression (as measured by the total HRS-D17 scores), no differences were found in the rate of melancholic depression by race, marital status, education, employment status, family history of depression, primary care versus specialty care, monthly income, and degree of psychiatric and medical co-morbidity. Melancholic depression was significantly more likely in men than women. Melancholic depression after adjustment for severity was associated with a slightly younger age at study entry, as well as with greater illness severity, and slightly shorter duration of current episode. Hispanic ethnicity was associated with lower melancholic depression rates at the .06 level of significance. CONCLUSIONS: Among outpatients with MDD, melancholic features were less likely in Hispanic patients, but more likely in slightly younger patients and in men. Melancholic features were also related to a slightly shorter current episode. These findings are consistent with the notion that external socio-demographic factors do not play an important role in the pathophysiology of melancholic depression.
BACKGROUND: The purpose of this paper is to use demographic and clinical data from a large diverse group of outpatients diagnosed with non-psychotic major depression to investigate the validity of the DSM-IV concept of melancholic depression. METHODS: Baseline clinical and demographic data were collected on 1500 outpatients (1456 of whom melancholia could be determined) with non-psychotic major depressive disorder (MDD) participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Depressive symptom severity was assessed by clinical telephone interview using the 17-item Hamilton Rating Scale for Depression (HRS-D17) and the 30-item Inventory of Depressive Symptomatology (IDS-C30). The types and degrees of concurrent psychiatric symptoms were measured using a self report, the Psychiatric Diagnostic Screening Questionnaire (PDSQ), by recording the number of items relevant to each diagnostic category endorsed by study participants. RESULTS: Adjusting for severity of depression (as measured by the total HRS-D17 scores), no differences were found in the rate of melancholic depression by race, marital status, education, employment status, family history of depression, primary care versus specialty care, monthly income, and degree of psychiatric and medical co-morbidity. Melancholic depression was significantly more likely in men than women. Melancholic depression after adjustment for severity was associated with a slightly younger age at study entry, as well as with greater illness severity, and slightly shorter duration of current episode. Hispanic ethnicity was associated with lower melancholic depression rates at the .06 level of significance. CONCLUSIONS: Among outpatients with MDD, melancholic features were less likely in Hispanic patients, but more likely in slightly younger patients and in men. Melancholic features were also related to a slightly shorter current episode. These findings are consistent with the notion that external socio-demographic factors do not play an important role in the pathophysiology of melancholic depression.
Authors: Richard Musil; Florian Seemüller; Sebastian Meyer; Ilja Spellmann; Mazda Adli; Michael Bauer; Klaus-Thomas Kronmüller; Peter Brieger; Gerd Laux; Wolfram Bender; Isabella Heuser; Robert Fisher; Wolfgang Gaebel; Rebecca Schennach; Hans-Jürgen Möller; Michael Riedel Journal: Int J Methods Psychiatr Res Date: 2017-06-14 Impact factor: 4.035
Authors: Nicole Vogelzangs; Adrie Seldenrijk; Aartjan T F Beekman; Hein P J van Hout; Peter de Jonge; Brenda W J H Penninx Journal: J Affect Disord Date: 2010-03-12 Impact factor: 4.839
Authors: Charlene Bryan; Thomas Songer; Maria Mori Brooks; Michael E Thase; Bradley Gaynes; Michael Klinkman; G K Balasubramani; A John Rush; Madhukar H Trivedi; Maurizio Fava; Stephen R Wisniewski Journal: Prim Care Companion J Clin Psychiatry Date: 2009
Authors: Charlotte L Haley; Sharon C Sung; A John Rush; Madhukar H Trivedi; Stephen R Wisniewski; James F Luther; Susan G Kornstein Journal: J Womens Health (Larchmt) Date: 2013-03 Impact factor: 2.681
Authors: Diane Warden; A John Rush; Stephen R Wisniewski; Ira M Lesser; Susan G Kornstein; G K Balasubramani; Michael E Thase; Sheldon H Preskorn; Andrew A Nierenberg; Elizabeth A Young; Kathy Shores-Wilson; Madhukar H Trivedi Journal: Int J Neuropsychopharmacol Date: 2008-07-09 Impact factor: 5.176
Authors: Susan G Kornstein; Marisa Toups; A John Rush; Stephen R Wisniewski; Michael E Thase; James Luther; Diane Warden; Maurizio Fava; Madhukar H Trivedi Journal: J Womens Health (Larchmt) Date: 2013-02 Impact factor: 2.681