Defining melancholia: the primacy of psychomotor disturbance

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Abstract

Objective

To argue that melancholia is a categorically distinct depressive condition, able to be differentiated from other depressive conditions by a neuropathological marker [observable psychomotor disturbance (PMD)] and having a differential response to various antidepressant treatments.

Method

The above statements are addressed by review of a wide body of research, which identified observable PMD as the cardinal marker of melancholia and developed the CORE measure as a strategy for assessing PMD and its severity. Properties of the CORE measure, including reliability, validity and treatment prediction, are overviewed.

Results

A case is made for defining melancholia and a strategy for establishing its probability.

Conclusion

Melancholia is positioned as a categorical entity capable of being circumscribed by its cardinal feature of PMD.

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