Is melancholia a distinct syndrome? Recurrence, chronicity, and severity give evidence in the 50 year follow-up of the Lundby Study

Introduction Whether melancholia is a distinct syndrome has long been debated. One aspect of valid whether it allows for determination prognosis. The aim this study to investigate the course melancholic depression versus non-melancholic with focus on: (i) time and probability recovery from first depressive episode, (ii) risk recurrence, (iii) rate (iv) or antidepressant medication, (v) suicide risk. Methods Lundby Study longitudinal community on mental health that followed geographically defined population ( N = 3,563) up 50 years, 1947–1997. Subjects onset were assessed as 46) 381) using DSM-IV specifier. These diagnoses made in retrospect all available information semi-structured interviews by psychiatrists, key informants, registers, patient records. Results We found no significant difference between melancholic- episode. recurrence was shorter than group 2.77 (95% confidence interval [CI] 1.83–4.20) times group. median higher group, at 0.19 recurrences per year (interquartile range [IQR] 0.08–0.47), compared 0.10 (IQR 0.05–0.21) p < 0.03). percentage being depressed medication 17% 3–20%), 8% 7–33%) 0.001). hazard ratio 4.13 CI 1.49–11.48, 0.01). Discussion To conclude, had more recurrent, chronic, severe did population. Although our use retrospective diagnosis might limit interpretation results, findings indicate may be useful determining prognosis psychopathological syndrome.