title: Pessimism, worthlessness, anhedonia, and thoughts of death identify DSM-IV major depression in hospitalized, medically ill patients.
abstract: BACKGROUND
  Major depression can be difficult to diagnose in medically ill patients, as distinct mood states may not be adequately differentiated. Previous research has found several dimensions of mood states, including demoralization (hopelessness/helplessness) and anhedonia (inability to experience pleasure). DSM-IV major depression was highly prevalent in the clusters of participants typified by high levels of demoralization, and to a slightly lesser extent, anhedonia.
  
  
  OBJECTIVE
  The present study provides a further analysis of 312 medically ill patients, examining how key individual symptoms of demoralization and anhedonia relate to DSM-IV major depression.
  
  
  METHODS
  The authors used logistic-regression and classification and regression-tree (CART) analysis to relate variables of demoralization/anhedonia and major depression.
  
  
  RESULTS
  Two combinations of symptoms 1) pessimism and worthlessness; and 2) pessimism, loss of interest in others, and thoughts of death, were highly associated with major depression.
  
  
  CONCLUSIONS
  The identification of key symptoms, particularly those involving pessimism, may aid clinical understanding and treatment of depression.
authors.affiliation: Monash Centre for Occupational and Environmental Health, Dept. of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004 Australia. dean.mckenzie@med.monash.edu.au
authors.forename: Dean P
authors.initials: DP
authors.lastname: McKenzie
authors.forename: David M
authors.initials: DM
authors.lastname: Clarke
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Forbes
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Sim
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D008875:Middle Aged; D009013:Morale; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult