Depression is a devastating and seriously disabling mental illness that despite notable progress in the field continues to challenge the medical community worldwide. Experts generally concede that (1) Neuropathophysiological studies of depression have resulted in contradictory findings; and (2) A major cause of these confusing findings is due to the weakness of the DSM-IV’s diagnostic classification of depression, which produces heterogeneity within groups included in neuroscientific studies. Researchers have suggested that the current DSM-IV criteria for both atypical depression (AD) and melancholia needs to be re-conceptualized. The purpose of the three studies described here was to examine whether new criteria may better define two distinct depressive subtypes than do current DSM-IV criteria sets, using the measures of pharmacologic dissection and perceptual asymmetry (PA). In study one, the current criteria for AD did not significantly predict response to a MAOI on either measure of remission nor did it predict a response to a TCA although on the HAM-D17 measure of remission is strongly in the right direction but not significant due to small sample size. Likewise, the criteria for somatic depression (SD) did not predict on either measure of remission a response to a MAOI, neither did it predict response to a TCA on one measure of remission (HAM-D17) but on a second measure of remission (QIDS-C30), it did predict response to a TCA at a borderline significance level using a chi-square test and at a significant level using the Fisher’s Exact probability test. In study two, the current criteria for melancholic depression did significantly predict response to a TCA on the HAM-D17 measure of remission but in the opposite direction from that reported in the literature and no significant difference was found on the QIDS-C30 measure of remission. Modified criteria for melancholic depression did not significantly predict response to a TCA on the HAMD17, however, they did predict response on the QIDS-C 30 in the predicted direction at a borderline significance level. In study three, the current criteria for AD versus melancholic depression did not yield a significant difference in PA. However, melancholic depression versus SD did predict differential PA at a borderline significance level in the opposite direction to that predicted. In conclusion, there is some support for a differential response by SD, suggestive of a distinct non-endogenous subtype of depression. The implications of these findings will be discussed.
|Commitee:||Anglin, Deidre, Fishbein, William, Floyd, Tiffany, Melara, Robert|
|School:||City University of New York|
|School Location:||United States -- New York|
|Source:||DAI-B 71/09, Dissertation Abstracts International|
|Subjects:||Cognitive psychology, Physiological psychology|
|Keywords:||Atypical depression, Cognitive responses, Depression, Depression classification, Melancholic depression, Perceptual asymmetry, Pharmacology, Somatic depression|
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