Mh. Turkcapar et al., The validity of diagnosis of melancholic depression according to differentdiagnostic systems, J AFFECT D, 54(1-2), 1999, pp. 101-107
Background: Melancholic versus nonmelancholic depression dichotomy is perha
ps the most widely accepted distinction in categorization of depression. Th
is research aims to compare RDC, DSM-III, DSM-III-R, DSM-IV and ICD-10 mela
ncholic/endogenous/somatic and nomelancholic/nonendogenous/nonsomatic depre
ssive patients with regards to biological variables thyroid stimulating hor
mone (TSH), basal and post dexamethasone cortisol levels, age, age of onset
of depression, psychosocial stressors, and severity of depression. Methods
: Sixty-five patients who had been diagnosed as having major depression acc
ording to DSM III-R, using SCID were included in this study. Patients were
divided into melancholic and nonmelancholic subtypes using RDC, DSM-III, DS
M III-R, DSM-IV and ICD-10 criteria and groups were compared on the basis o
f biological variables, as well as age, psychosocial stressors and the seve
rity of depression. Results: RDC endogenous depressives were older, more se
verely depressed and had higher cortisol levels then RDC nonendogenous depr
essives. DSM III-R melancholics were older, more severely depressed, report
ed fewer numbers of psychosocial stressors and had lower levels of TSH than
nonmelancholics. DSM-IV melancholics were more severely depressed, had hig
her basal and post dexamethasone cortisol levels and lower TSH levels. The
ICD 10 somatic depression group contained more severe, older depressives wi
th lower TSH levels. Conclusion: The results of this research show that dif
ferent criteria may identify different groups of patients as having melanch
olic depression. They also partly support the hypothesis that endogenous or
melancholic depression have a biological basis. Limitations of study: The
study involved a relatively small sample size from a single centre and the
results are based on this relatively small sample. (C) 1999 Elsevier Scienc
e BN. All rights reserved.