Gordon Parker1, Stacey McCraw2. 1. School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia. Electronic address: g.parker@unsw.edu.au. 2. School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia.
Abstract
BACKGROUND: The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS: All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review. RESULTS: Findings suggest high reliability in quantifying CORE scores can be achieved and that it has construct validity as a measure of PMD. A number of application studies assessing socio-demographic factors, cognitive and motor impairment, dexamethasone suppression and thyrotropin-releasing hormone, response to psychotherapy and to electroconvulsive therapy support its validity as a measure of melancholia, while functional brain imaging studies suggest that the measure identifies regions of decreased connectivity. LIMITATIONS: Use of the CORE benefits from rater training and for subjects to be assessed at or near nadir of their depressive episode. There have been insufficient studies evaluating genetic factors, and the treatment response of CORE-defined melancholic patients to antidepressant drugs of differing classes. CONCLUSIONS: The CORE, either as a proxy or direct measure of melancholia, provides a strategy for assigning depressed subjects a diagnosis or melancholic or non-melancholic depression or for estimating the probability of melancholia.
BACKGROUND: The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS: All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review. RESULTS: Findings suggest high reliability in quantifying CORE scores can be achieved and that it has construct validity as a measure of PMD. A number of application studies assessing socio-demographic factors, cognitive and motor impairment, dexamethasone suppression and thyrotropin-releasing hormone, response to psychotherapy and to electroconvulsive therapy support its validity as a measure of melancholia, while functional brain imaging studies suggest that the measure identifies regions of decreased connectivity. LIMITATIONS: Use of the CORE benefits from rater training and for subjects to be assessed at or near nadir of their depressive episode. There have been insufficient studies evaluating genetic factors, and the treatment response of CORE-defined melancholic patients to antidepressant drugs of differing classes. CONCLUSIONS: The CORE, either as a proxy or direct measure of melancholia, provides a strategy for assigning depressed subjects a diagnosis or melancholic or non-melancholic depression or for estimating the probability of melancholia.
Authors: M G A Van Cauwenberge; F Bouckaert; K Vansteelandt; C Adamson; F L De Winter; P Sienaert; J Van den Stock; A Dols; D Rhebergen; M L Stek; L Emsell; M Vandenbulcke Journal: Transl Psychiatry Date: 2021-04-01 Impact factor: 6.222
Authors: Claire R van Genugten; Josien Schuurmans; Adriaan W Hoogendoorn; Ricardo Araya; Gerhard Andersson; Rosa M Baños; Thomas Berger; Cristina Botella; Arlinda Cerga Pashoja; Roman Cieslak; David D Ebert; Azucena García-Palacios; Jean-Baptiste Hazo; Rocío Herrero; Jérôme Holtzmann; Lise Kemmeren; Annet Kleiboer; Tobias Krieger; Anna Rogala; Ingrid Titzler; Naira Topooco; Johannes H Smit; Heleen Riper Journal: Front Psychiatry Date: 2022-03-17 Impact factor: 4.157