title: Clinical differences between melancholic and nonmelancholic depression as defined by the CORE system.
abstract: BACKGROUND
  The definition and delineation of melancholia have remained elusive for an extended period. A longstanding signal of psychomotor disturbance has been operationalized via the observer-rated CORE measure and with CORE-assigned melancholic and nonmelancholic compared in several Australian studies. Replication studies in other regions have not previously been reported. This study compares Brazilian patients with melancholic and nonmelancholic depression according to the CORE measure of psychomotor disturbance in terms of clinical characteristics, suicide ideation, stressful life events, quality of life, parental care, and personality styles.
  
  
  METHODS
  A total of 181 patients with unipolar major depression attending a tertiary care outpatient service in Brazil were evaluated in relation to melancholic status and study variables.
  
  
  RESULTS
  The CORE-assigned melancholic patients presented higher symptom severity, greater prevalence of suicide ideation, and Axis I comorbidities than nonmelancholics. Scores of dysfunctional personality styles and dysfunctional parental care measures were also higher among melancholics. Quality-of-life scores were low in both groups.
  
  
  CONCLUSIONS
  The absence of a criterion standard for the diagnosis of melancholia and the use of medication can be potential limitations of the study.
  
  
  CONCLUSIONS
  Differences suggest that CORE-assigned melancholia defines a distinct group of patients and probably a disorder distinct from nonmelancholic depression not only in quantitative but also in qualitative aspects.
authors: Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-003, Brazil. mkcald@gmail.com
authors: Marco Antonio Knob
authors: MA
authors: Caldieraro
authors: Fernanda Lucia Capitanio
authors: FL
authors: Baeza
authors: Diesa Oliveira
authors: DO
authors: Pinheiro
authors: Mariana Rangel
authors: MR
authors: Ribeiro
authors: Gordon
authors: G
authors: Parker
authors: Marcelo P
authors: MP
authors: Fleck
mesh_terms: D000328:Adult; D001938:Brazil; D003865:Major Depressive Disorder / Q000145:classification / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010551:Personality; D011596:Psychomotor Disorders / Q000150:complications / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D059020:Suicidal Ideation