Major depression with or without melancholia

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The cardinal triad of symptoms of depression is as follows: emotional symptoms, psychomotor symptoms, and negative beliefs. Not surprisingly, this triad is more obvious in major depression than in mild depression. Diagnosis of major depression according to DSM-IV requires at least five of the nine symptoms in Table 1, and

ICD-10 requires six of the ten symptoms in Table.!.. Negative beliefs such as 'loss of self-esteem' or 'inappropriate guilt' are the core symptoms of major depression. Inappropriate guilt is experienced as punishment for past misdeeds (prior to the current episode of depression). The prevailing element of negative beliefs is a sense of loss which is associated with lower self-esteem experienced retrospectively.(9) The symptom which discriminates best between anxiety states and major depressive disorder is guilt. (1°>

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