Melancholia : a disorder of movement and mood : a phenomenological and neurobiological review

It has long been accepted that depressive disorders comprise a biologically-based type, the so-called endogenous or melancholic depression, and a residual set of depressive conditions resulting from social factors. The difficulty has been in distinguishing the melancholic type of depression on the basis of clinical features. This book describes the development of a behavioral sign-based approach, the CORE system, and demonstrates its superiority to previous symptom-based diagnostic systems for depression. The authors suggest that the psychomotor signs elicited may indicate the likely pathogenesis of melancholic depression, involving the basal ganglia and connections to the frontal cortex. This is therefore a challenging new account of the classification and neurobiology of depression, which is certain to interest all clinicians involved in the evaluation or treatment of such patients. The CORE measure itself is incorporated as an appendix. The book contains black-and-white illustrations. Cover......Page 1 Frontmatter......Page 2 Contents......Page 6 List of contributors......Page 8 Acknowledgments......Page 10 Introduction......Page 12 Part One - Classification and Research: Historical and Theoretical Aspects......Page 18 1 - Issues in Classification: I. Some Historical Aspects......Page 20 2 - Issues in Classification: II. Classifying Melancholia......Page 31 3 - Issues in Classification: III. Utilising Behavioural Constructs in Melancholia Research......Page 49 4 - Issues in Classification: IV. Some Statistical Aspects......Page 68 Part Two - Development and Validation of a Measure of Psychomotor Retardation as a Marker of Melancholia......Page 76 5 - Psychomotor Change as a Feature of Depressive Disorders: Historical Overview and Current Assessment Strategies......Page 78 6 - Development and Structure of the CORE System......Page 93 7 - Reliability of the CORE Measure......Page 141 8 - Validity of the CORE: I. A Neuroendocrinological Strategy......Page 149 9 - Validity of the CORE: II. Neuropsychological Tests......Page 160 10 - Validity of the CORE: III. Outcome and Treatment Prediction......Page 171 11 - Phenotypic Expression of Melancholia Contrasted for Those with Bipolar and Unipolar Illness Courses......Page 183 12 - Psychotic Depression: Clinical Definition, Status and the Relevance of Psychomotor Disturbance to Its Definition......Page 190 13 - A Clinical Algorithm for Defining Melancholia: Comparison with Other Sub-typing Measures......Page 213 14 - Rating the CORE: A User's Guide......Page 222 Part Three - The Neurobiology of Melancholia......Page 232 15 - Melancholia as a Neurological Disorder......Page 234 16 - Melancholia and the Ageing Brain......Page 248 17 - Magnetic Resonance Imaging in Primary and Secondary Depression......Page 263 18 - Functional Neuroimaging in Affective Disorders......Page 278 19 - Summary and Conclusions......Page 288 The CORE Measure: Procedural Recommendations and Rating Guidelines......Page 293 References......Page 303 Author Index......Page 335 Subject Index......Page 346 It has long been accepted that depressive disorders comprise a biologically-based type, the so-called 'endogenous' or 'melancholic' depression, and a residual set of depressive conditions resulting from social factors. The difficulty has been in distinguishing the melancholic type of depression on the basis of clinical features. This book describes the development of a behavioral sign-based approach, the CORE system, and demonstrates its superiority to previous symptom-based diagnostic systems for depression. The authors suggest that the psychomotor signs elicited may indicate the likely pathogenesis of melancholic depression, involving the basal ganglia and connections to the frontal cortex. This is therefore a challenging new account of the classification and neurobiology of depression, that is certain to interest all clinicians involved in the evaluation or treatment of such patients. The CORE measure itself is incorporated as an appendix It has long been accepted that depressive disorders comprise a biologically based type-the-so-called 'endogenous' or 'melancholic' depression and a residual set of depressive conditions resulting from personality style, developmental factors, and social stressors. The difficulty has been in distinguishing the melancholic type of depression on the basics of clinical features. Describes the development of a behavioral approach to the diagnosis of depression, the CORE system, and demonstrates its superiority to previous symptom-based diagnostic systems. The authors suggest that the psychomotor signs elicited may indicate the likely pathogenesis of melancholic depression. The CORE measure itself is incorporated as an appendix. The classification of the various types of depression - if types there be - is still to be resolved.