Predicting the course of melancholic and nonmelancholic depression. A naturalistic comparison study

J Nerv Ment Dis. 1992 Nov;180(11):693-702. doi: 10.1097/00005053-199211000-00003.

Abstract

We assessed improvement patterns and predictors of outcome over a 1-year period, in a sample of depressed patients receiving treatment from a specialized mood disorders unit. Patients with melancholia had a differential improvement pattern from the nonmelancholics in the first 20 weeks, but case rates and severity levels were comparable at 20 weeks and at 1 year. Only three variables (older age at first episode, less severe depression and extraversion) were predictors of improvement in both groups. Improvement was predicted by less psychomotor disturbance, absence of personality disorder, and higher social functioning in the melancholic patients. A reported absence of timidity and shyness in childhood, a briefer duration of depression, and receipt of individual psychotherapy predicted a better outcome in the nonmelancholic patients. Although significant predictors were few overall, the suggested differential relevance for most of the isolated predictors argues for outcome studies that examine melancholic and nonmelancholic depressive disorders separately.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Diagnosis, Differential
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Personality Disorders / complications
  • Personality Disorders / diagnosis
  • Probability
  • Prognosis
  • Psychomotor Disorders / complications
  • Psychomotor Disorders / diagnosis
  • Psychotherapy
  • Psychotropic Drugs / therapeutic use
  • Severity of Illness Index
  • Social Adjustment
  • Treatment Outcome

Substances

  • Psychotropic Drugs