Clinical, cognitive, and sociodemographic variables in melancholic versus nonmelancholic depression

Abstract

Introduction: The “biological” symptoms in some depressive illnesses are loss of sleep, appetite and weight, psychomotor changes, decreased libido, etc., Those in the remaining forms of depression include anxiety, phobias, and obsessional symptoms. These two groups of symptoms constitute melancholic and nonmelancholic depression, respectively. This research aimed at studying the clinical, cognitive, and sociodemographic profiles in melancholic and nonmelancholic depression. Methods: This cross-sectional, observational study was conducted in a tertiary care teaching hospital among 60 in-patients over a period of 1 year following clearance from the Institutional Ethics Committee. Among the total 60 participants enrolled, 30 met criteria for depression with melancholic features and 30 had depression without melancholic features according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Patients were administered a specialized pro forma to record the demographic, medical, psychiatric, and other relevant clinical data. Hamilton's Depression Rating Scale was used for assessing severity of depression; Clinical Outcomes in Routine Evaluation (CORE) Questionnaire was used to assess melancholic features; and cognitive assessment was done using Mini-Mental State Examination (MMSE) and semantic verbal fluency test. Suicide ideation was assessed using the Modified Suicide Ideation Scale. Results: Our study showed a statistically significant difference in CORE score, MMSE, semantic verbal fluency, and Modified Suicide Ideation Sscale scores, all with P < 0.001 in the melancholic group compared to nonmelancholic group; however, Hamilton depression scores were not significantly different between them with P < 0.264. Conclusion: Melancholic depression differs from nonmelancholic depression in various clinical and cognitive aspects, with more cognitive deficits and suicide ideation in the melancholic group.