Defining melancholia: the primacy of psychomotor disturbance.
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.


METHODS
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.


CONCLUSIONS
Melancholia is positioned as a categorical entity capable of being circumscribed by its cardinal feature of PMD.
Parker
G
G
School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, NSW, Australia. g.parker@unsw.edu.au
D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D009415:Nerve Net / Q000503:physiopathology; D011379:Prognosis; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000928:Antidepressive Agents