Attempts to validate melancholic depression: some observations on modern research methodology

The use of the word "melancholia" or its variants is quite old in the English language, originally referring to a variety of dysphoric states of everyday life. With the development of psychiatry as a branch of medicine in the late 18th century, melancholia was used in a medical context to describe morbid states of depressed mood and associated features. The concept of melancholia as a specific subtype of a broader illness known as "depressive disorder" is fairly recent in modern psychiatry, arising predominantly in Great Britain and becoming a formal part of mood disorder nosology in 1980 with the DSM-III. Despite attempts to validate the concept of melancholia as an illness separate from nonmelancholic depression, no consensus has been reached. In this article, the author outlines what he believes are methodological problems that have been common in research studies to validate melancholia.