A Comparison of Melancholic and Nonmelancholic Recurrent Major Depression in Han Chinese Women

Abstract

BackgroundAlthough the diagnosis of melancholia has had a long history, the validity of the current DSM-IV definition remains contentious. We report here the first detailed comparison of melancholic and nonmelancholic major depression (MD) in a Chinese population examining in particular whether these two forms of MD differ quantitatively or qualitatively.MethodsDSM-IV criteria for melancholia were applied to 1,970 Han Chinese women with recurrent MD recruited from 53 provincial mental health centers and psychiatric departments of general medical hospitals in 41 cities. Statistical analyses, utilizing Student's t-tests and Pearson's χ2, were calculated using SPSS 13.0.ResultsMelancholic patients with MD were distinguished from nonmelancholic by being older, having a later age at onset, more episodes of illness and meeting more A criteria. They also had higher levels of neuroticism and rates of lifetime generalized anxiety disorder, panic disorder, and social and agoraphobia. They had significantly lower rates of childhood sexual abuse but did not differ on other stressful life events or rates of MD in their families.DiscussionConsistent with most prior findings in European and US populations, we find that melancholia is a more clinically severe syndrome than nonmelancholic depression with higher rates of comorbidity. The evidence that it is a more “biological” or qualitatively distinct syndrome, however, is mixed.

Demographic and Clinical Features and Prescribing Patterns of Psychotropic Medications in Patients with the Melancholic Subtype of Major Depressive Disorder in China

“…Unlike previous findings in Western settings that melancholic patients have a larger number of episodes and increased familial loading [16], [22], in this study melancholia was associated with less family history of psychiatric disorders and lifetime depressive episodes.…”

“…Our result is similar to the findings in MDD patients from Western countries; for example 50% in a US community sample [22] and 44% in New Zealand outpatients [10], but considerably lower than a recent finding in China [16]. In a convenience sample of 1,970 female Chinese MDD patients 81.3% were diagnosed as melancholia based on the CIDI [16]. The wide discrepancy between Sun et al’s finding and ours might be due to selection bias (convenience vs. consecutive sampling; female sex vs. both sexes) and interviewing techniques (the CIDI vs. MINI).…”

Polygenic risk for severe psychopathology among Europeans is associated with major depressive disorder in Han Chinese women

“…Only neuroticism PRS were associated with the less severe, non-melancholic MDD subtype. This association is consistent with previous research observing neuroticism to be higher among women with a history of non-melancholic depression (Kendler, 1997), though an earlier analysis of the CONVERGE sample observed higher N among the MEL group (Sun et al 2012). Furthermore, a study reported a strong genetic correlation (rG = 0.64) between neuroticism and MDD in the PGC (Smith et al 2016), though the samples included were primarily of European ancestry.…”

Enhancing multi-center generalization of machine learning-based depression diagnosis from resting-state fMRI

“…This can be the reason why the classification performance was affected by the site rather than the diagnostic label. We then focused on melancholic depression that is a subtype of major depressive disorder with biological homogeneity [20][21][22]. The classification performance between melancholic patients and healthy controls was slightly higher than the one between major depressed patients, including non-melancholic patients and healthy controls ( Figure 4).…”