MDDM

Major Depressive Disorder with Melancholic Features (MDDM) is a subtype of Major Depressive Disorder (MDD) characterized by specific symptoms that differentiate it from other forms of depression. MDDM is marked by a profound lack of pleasure in all or almost all activities, a deeper than usual depression in the morning, significant weight loss or loss of appetite, excessive guilt, and psychomotor agitation or retardation. This condition is diagnosed based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), currently in its fifth edition (DSM-5).

Symptoms

The hallmark of MDDM is the presence of melancholic features during a depressive episode. These features include:

• A distinct quality of depressed mood characterized by a profound despondency, despair, and/or emptiness
• Lack of response to what normally would be pleasurable activities (Anhedonia)
• Worsening of symptoms in the morning
• Early morning awakening
• Significant weight loss or decrease in appetite
• Excessive or inappropriate guilt
• Psychomotor agitation or retardation (observable by others)
• Consistent lack of mood reactivity to usually pleasurable stimuli

Diagnosis

Diagnosis of MDDM requires a thorough clinical assessment by a healthcare professional. The DSM-5 criteria for Major Depressive Disorder with Melancholic Features must be met, including the presence of at least one of the two core symptoms (loss of pleasure in all or almost all activities or lack of reactivity to usually pleasurable stimuli) in addition to three or more of the other symptoms listed above.

Treatment

Treatment for MDDM often involves a combination of antidepressant medication and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are commonly prescribed medications. Psychotherapy approaches, such as Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT), have also been effective in treating MDDM. In some severe cases, Electroconvulsive Therapy (ECT) may be considered.

Epidemiology

The prevalence of MDDM within the population of individuals diagnosed with Major Depressive Disorder varies. However, it is considered a common subtype, with certain populations showing higher rates of melancholic features.

Prognosis

The prognosis for individuals with MDDM can vary. With appropriate treatment, many individuals experience significant improvement in their symptoms. However, MDDM is often associated with a higher severity of depression and may require more intensive treatment strategies.

See Also

• Depression
• Bipolar Disorder
• Mood Disorders
• Psychiatry