A case for reprising and redefining melancholia

Abstract

Objective: To identify limitations to severity-based classifications of depression, and to argue for positioning melancholia as a distinct melancholic subtype. Method: An overview of relevant literature was conducted. Results: First, dimensionalizing depressive disorders effectively aggregates multiple heterogeneous depressive types and syndromes, and thus limits, if not prevents, identification of differential causes and treatments. Second, the melancholic depressive subtype can be defined with some relative precision, and that as it shows quite distinct differential treatment responsiveness, identification should be a clinical priority. Conclusion: Melancholia can be positioned and classified as a distinct depressive subtype.