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The Interdependence of Subtype and Severity: Contributions of Clinical and Neuropsychological Features to Melancholia and Non-melancholia in an Outpatient Sample

Published online by Cambridge University Press:  03 February 2012

Candice Quinn
Affiliation:
Discipline of Psychiatry, University of Sydney, Sydney, NSW
Anthony Harris
Affiliation:
Discipline of Psychiatry, University of Sydney, Sydney, NSW Brain Dynamics Centre, University of Sydney, Westmead, NSW Westmead Millennium Institute, University of Sydney, Westmead, NSW
Andrew Kemp*
Affiliation:
School of Psychology, University of Sydney, Sydney, NSW
*
Correspondence and reprint requests to: Andrew Kemp, The School of Psychology, Brennan MacCallum Building (A18), University of Sydney, NSW 2006, Australia. E-mail: andrew.kemp@sydney.edu.au

Abstract

Major depressive disorder is often considered to be a homogenous disorder that changes in terms of severity; however, the presence of distinct subtypes and a variety of presenting symptoms suggests much heterogeneity. Aiming to better understand the relationship between heterogeneity and diagnosis we used an exploratory approach to identify subtypes of depression on the basis of clinical symptoms and neuropsychological performance. Cluster analysis identified two groups of patients distinguished by level of cognitive dysfunction with the more severe cluster being associated with melancholic depression. While the relationship between cluster and subtype was significant, only 58% of melancholic patients were assigned to cluster 1 (the more severe cluster) and 66% of non-melancholic patients assigned to cluster 2. Subtypes also displayed a distinctive profile of impairment such that melancholic patients (n = 65) displayed more variability in attention while non-melancholic patients (n = 59) displayed memory recall impairment. While melancholia and non-melancholia are associated with a more severe and less severe form of depression respectively, findings indicate that differences between melancholia and non-melancholia are more than simple variation on severity. In summary, findings provide support for the heterogeneity of depression. (JINS, 2012, 18, 361–369)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2012

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