title: Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure.
abstract: BACKGROUND
  The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers.
  
  
  METHODS
  Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS]), and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma) were analyzed.
  
  
  RESULTS
  Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39%) of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients) and TBARS (compared with both the nonmelancholic subset and controls) and returned higher IL-6 levels than controls. Both depressive groups generated higher PCC scores than controls, with no difference between melancholic and nonmelancholic subsets.
  
  
  CONCLUSIONS
  A sign-based measure to rate melancholia was able to replicate and extend biological findings discriminating melancholic depression. Signs of psychomotor disturbance may be a useful diagnostic measure of melancholia.
authors.affiliation: Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Department of Psychiatry, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Spanemberg
authors.affiliation: Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Caldieraro
authors.affiliation: Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Edgar Arrua
authors.initials: EA
authors.lastname: Vares
authors.affiliation: INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Wollenhaupt-Aguiar
authors.affiliation: INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Márcia
authors.initials: M
authors.lastname: Kauer-Sant'Anna
authors.affiliation: Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Sheila Yuri
authors.initials: SY
authors.lastname: Kawamoto
authors.affiliation: INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Centro Universitário Metodista, Porto Alegre, Brazil.
authors.forename: Emily
authors.initials: E
authors.lastname: Galvão
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia ; Black Dog Institute, Sydney, NSW, Australia.
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
authors.affiliation: Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, ON, Canada.
authors.forename: Marcelo P
authors.initials: MP
authors.lastname: Fleck
keywords: brain-derived neurotrophic factor; inflammatory cytokines; melancholic depression; oxidative stress