Should psychomotor disturbance be an essential criterion for a DSM-5 diagnosis of melancholia?

BMC Psychiatry

Research Article

John Snowdon¹ 

[1] Discipline of Psychological Medicine, University of Sydney, Concord Hospital, 2139, Sydeny, NSW, Australia;

关键词: Depression;    Melancholia;    Psychotic depression;    Rating scales;    Psychomotor retardation;    Diagnostic classification systems;    Aged;   

DOI  :  10.1186/1471-244X-13-160

 received in 2012-09-03, accepted in 2013-05-13,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe CORE measure has proved useful in rating observed psychomotor disturbance (PMD), which has been held to be a key feature of melancholic depression. However, studies have shown a substantial percentage of subjects fulfilling DSM criteria for melancholia do not have observable PMD.MethodsA semi-structured interview schedule was used in assessing and diagnosing depressed older patients. DSM-IV diagnoses were made, and the CORE measure was used to rate PMD. Comparisons were made between melancholia inpatients who scored low and those scoring high on the CORE in relation to presentation and pattern of symptoms.ResultsOf 32 inpatients with melancholia, 10 scored 0–7, 8 scored 8–10, and 14 scored 15 or more on the CORE. Thirty-two inpatients with psychotic depression scored 13 or more. High-CORE participants manifested unvarying depression more often than did low-CORE participants, and were less likely to state that stress precipitated their depressive episode.ConclusionsHigh-CORE melancholia cases appear to have more in common with psychotic depression than do low-CORE cases. Designation of observable PMD as an essential criterion in making a diagnosis of melancholia could increase the utility of the DSM classification in relation to treatment planning.

【 授权许可】

CC BY   
© Snowdon; licensee BioMed Central Ltd. 2013