The treatment validity of DSM-III melancholic subtyping

Because melancholic subtyping is associated with pretreatment symptom severity, the type of data-analytic technique used in examining treatment validity may affect one's conclusions. We examined the relationship between the presence or absence of melancholia and the response to electroconvulsive therapy (ECT) in 87 depressed inpatients. Depending on the definition of improvement used, melancholic subtyping was either not associated with ECT response, or non-melancholics had a better outcome than melancholics. We suggest that standard methods of outcome evaluation be required in therapy outcome studies.