Melancholia: Past and present.

Patients in the contemporary period (1995-2010, compared with 1875-1924) at first admission for severe depressive disorders are more likely at an older age, more likely to go on to die by suicide, and will have much more frequent admissions. The data from this study support classical perceptions of melancholia. The poor outcomes in contemporary cases […]

Melancholic features and hostility are associated with suicidality risk in Asian patients with major depressive disorder.

Background Suicide rates are higher in East-Asians than other populations, and especially high in Koreans. However, little is known about suicidality risk and melancholic features in Asian patients with major depressive disorder (MDD). Method Drug-free MDD outpatients were included from 13 centers across five ethnicities consisting of Chinese (n=290), Korean (n=101), Thai (n=102), Indian (n=27), […]

Melancholia and the Probability and Lethality of Suicide Attempts

The authors compared suicide attempts associated with melancholic versus non-melancholic major depression in 377 patients. Controlling for depression severity & other covariates, melancholia at baseline assessment was associated with more serious past suicide attempts & with the probability of suicide attempt during follow-up. (24 refs.)

Melancholy and Suicide


Analytic Understanding of Suicide

Published in “Suicide Risk & Protective Factors in the New Millennium,” ed. by O T Grad

The Occurrence of Suicide in Severe Depression Related to the Months of the Year and the Days of the Week

This study investigated the distribution of suicide during the months of the year & the days of the week in people with severe depression. 1,206 Swedish inpatients with severe depression from 1956 to 1969 were included. 114 of these patients died by suicide. There was a significant peak in October/November for men. There was a […]

Biological Correlations of Suicide and Aggressivity in Major Depressions (With Melancholia): 5-Hydroxyindoleacetic Acide and Cortisol…

5-Hydroxyindoleacetic acid (5-HIAA) & cortisol in cerebrospinal fluid (CSF), response of the dexamethasone suppression test (DST) & the clinical response to treatment with 5-hydroxytryptophan (5-HTp) plus carbidopa were studied in a group of 21 depressed inpatients in order to correlate biological findings with psychopathological ones. A positive correlation was found between strong suicidal thoughts, suicidal […]

Agitated Depression as a Mixed State and the Problem of Melancholia

After a review of the literature on melancholia agitata & on the concept & clinical forms of mixed states, the psychopathology of agitated depression is discussed. Clinical forms are described, & new diagnostic criteria are proposed. The term “mixed depression” is proposed for all forms of agitated depression.

Music and Melancholia

This paper examines the psychiatric ailments of some of the great composers: two committed suicide, four suffered from severe depression, three had other ailments; & three had manic-depressive illnesses. The mood swings of these composers are compared with their periods of intense composition. For some, it seems that they were most productive immediately after a […]

Darkness Visible (IN: On Suicide: Great Writers on the Ultimate Question, edited by J Miller)

This excerpt from “Darkness Visible” relates Styron’s experiences with major depression. Styron describes the course of his illness, his decision to commit suicide, & the event that changed his mind & caused him, instead, to seek help for his depression.

Robert Clive

This biography presents the story of Robert Clive who went to India as a clerk with the East India Company in 1744. The war over the Austrian succession in 1746 marked the beginning of Clive’s military career. When Clive returned to England for the final time in 1768, he had had enormous military & business […]

Lower Degree of Esterification of Serum Cholesterol in Depression: Relevance for Depression and Suicide Research

This article reports on serum concentrations of total & free cholesterol & the esterified cholesterol ratio in 85 subjects. Depressed subjects & relatives of melancholic subjects had a significantly lower esterified cholesterol ratio than controls. No significant differences in total or free cholesterol concentrations were found between the study groups. Lower esterification in serum cholesterol […]

Vincent: the Self-Portraits

The self-portraits of Vincent Van Gogh are examined in the context of his tragic life experience, ending in psychosis & suicide. The self-portraits are seen as repeated & unresolved efforts at self exploration & self-definition in an attempt to add a sense of continuity & cohesion to a fragile & fragmented self-experience. The portraits are […]

Alan Ladd

Case study of Alan Ladd, a description of his childhood, his career path as an actor, and the possibility of his accidental death being a suicide as the timing and the circumstances fit a suicidal description.

Risk Factors for Suicide in Melancholia: a Case-Record Evaluation of 89 Suicides and Their Controls

This study is an investigation of 89 inpatients with primary severe depression and melancholia. In major depression withmelancholia rather than major depression in general, social variables appear to be less important in the prediction of suicide. There was a pronounced variation in suicide rates when sex differences were accounted for. (38 refs.)

Cerebrospinal Fluid Monoamine Metabolites and Suicidal Behavior in Depressed Patients: a 5-Year Follow-up Study

A 5-year follow-up study of suicidal behavior among depressed patients who earlier had determinations of cerebrospinal fluid (CSF) levels of monoamine metabolites. Reattempters, especially melancholic patients, had significantly lower CSF levels of the serotonin metabolite 5-hydroxyindoleacetic acid & dopamine metabolite homovanillic acid. Thus reduced CSF levels may be related to further suicidal behavior among depressed […]

Dreams and Depression: the Case of a 65-Year-Old Man

Describes the successful dream therapy of a 65 yr old man complaining of chronic anhedonia and suicidal ideation. 3 refs.

Diagnostic Criteria for Melancholia: The Comparative Validity of DSM-III and DSM-III-R

Psychometric properties & validity of DSM-III & DSM-III-R definitions of melancholia were examined in 60 depressed inpatients. According to both definitions melancholics had less stress, greater symptom severity, & less frequent nonserious suicide attempts prior to admission. (CM)

Phenomenological Analysis of Suicidal Schizophrenics

Previous research indicated that suicidal schizophrenics have significantly more episodes of depression than non-suicidal schizophrenics. This study goes one step further by determining which depressive symptoms are more prevalent. Analysis reveals that suicidal schizophrenics differ on a number of phenomenological variables (e.g., pathological guilt, nervous tension, hopelessness) which could be used as indicators of an […]

Affective Disorders and Aggression Disorders: Evidence for a Common Biological Mechanism

Van Praag reviews recent biochemical research & concludes that most studies have found a correlation between suicidal behavior & low levels of CSF 5-HIAA; that evidence of a connection between violence & the attempt is equivocal and that the theory that low CSF 5-HIAA levels predict increased suicide risk has not yet been confirmed. The […]

Depressive Disorders in 100 Adolescents Who Attempted Suicide

Sex of a Case History and the DSM-III Diagnosis of Depression

The purpose of this study was to examine the hypothesis that male clinicians ware more likely to label & diagnose women as depressed. Subjects were clinical psychologists & psychiatrists listed in professional directories of the American Psychological & Psychiatric Societies. Questionnaires & a case history of an attempted suicide were mailed to the subjects. 1/2 […]

Psychomotor Retardation and Agitation in Depression: Relationship to Age, Sex, and Response to Treatment

Patients with primary affective disorder who had either psychomotor agitation alone or psychomotor retardation alone were studied. Compared to psychomotor retardation, psychomotor agitation appears to be seen more frequently in women, older patients, and individuals who have a late onset to their illness. In addition, those with agitation alone appeared to have a better and […]