title: The morbidity and mortality linked to melancholia: two cohorts compared, 1875-1924 and 1995-2005.
abstract: For over a century, melancholia has been linked to increased rates of morbidity and mortality. Data from two epidemiologically complete cohorts of patients presenting to mental health services in North Wales (1874-1924 and 1995-2005) have been used to look at links between diagnoses of melancholia in the first period and severe hospitalized depressive disorders today and other illnesses, and to calculate mortality rates. This is a study of the hospitalized illness rather than the natural illness, and the relationship between illness and hospitalization remains poorly understood. These data confirm that melancholia is associated with a substantial increase in the standardized mortality rate both formerly and today, stemming from a higher rate of deaths from tuberculosis in the historical sample and from suicide in the contemporary sample. The data do not link melancholia to cancer or cardiac disease. The comparison between outcomes for melancholia historically and severe mood disorder today argue favourably for the effectiveness of asylum care.
authors.affiliation: Hergest Unit, Bangor, Wales.
authors.forename: Margaret
authors.initials: M
authors.lastname: Harris
authors.forename: Fiona
authors.initials: F
authors.lastname: Farquhar
authors.forename: David
authors.initials: D
authors.lastname: Healy
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Le Noury
authors.forename: Stefanie C
authors.initials: SC
authors.lastname: Linden
authors.forename: J Andrew
authors.initials: JA
authors.lastname: Hughes
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Roberts
keywords: Depressive psychosis; hospitalization; melancholia; morbidity; mortality