Cluster analytic validation of the DSM melancholic depression. The threshold model: integration of quantitative and qualitative distinctions between unipolar depressive subtypes.
Cluster analysis was performed on the DSM-III symptoms of major depression and symptoms of melancholia identified in a study group consisting of 220 unipolar depressed inpatients a melancholic and non-melancholic cluster. Patients allocated to the melancholic cluster were more severely depressed and they were characterized by psychomotor disorders, a distinct quality of mood, diurnal variation, early morning awakening, and non-reactivity. Our results support the construct validity of the DSM-III melancholic subtype of major depression. This study supports the integrated threshold model:. (i) melancholic and non-melancholic depression may be regarded as continuous classes in terms of overall severity of depression; and (ii) both groups form discrete categories with regard to the melancholic symptoms, which emerge as the severity of depression increases.
Schotte
C K
CK
Department of Psychiatry, Antwerp University Hospital (U.Z.A.), Edegem, Belgium.
Maes
M
M
Cluydts
R
R
Cosyns
P
P
D000275:Adjustment Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D019263:Dysthymic Disorder / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D015203:Reproducibility of Results