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In a study of patients watching emotionally evocative movies, the responses of people with a form of depression known as melancholia were distinctly different from those of patients with a less severe form of the depression.
This discovery could lead to a diagnosis of melancholia sooner, helping patients get the right treatment quickly to avoid the more invasive interventions that might be required if the diagnosis is delayed.
"For basically as long as depression has been recognized as a condition, as far back as the times of the ancient Greeks, it's been noted that there are some people with depression that seem to get a very physical presentation," neuropsychiatrist Philip Mosley of QIMR Berghofer Medical Research Institute in Australia told ScienceAlert.
"So they stop eating, they lose the ability to sleep, they seem slowed down as if they're walking through concrete. Their speed of thought reduces markedly, and they are often very sick."
Called melancholia, this sub-type of depression often fails to respond well to psychological treatments. Mosley describes the research as an effort to create a toolbox that allows specialists to diagnose types of depression with a degree of precision that permits a prompt, tailored approach.
Melancholia affects around five to 10 percent of all people with depression, and it can often be challenging to diagnose. The later it is diagnosed, the more likely it is the patient may need a stronger treatments such as electroconvulsive therapy or transcranial magnetic stimulation. These treatments are very effective, but also can feel intimidating and invasive.
For early diagnoses, medication can be quite effective, and that is what Mosley and his colleagues are trying to achieve.
Other studies at QIMR Berghofer involve the use of emotional videos to study the responses of people with various neurological and psychological conditions. Since one of the manifestations of melancholic depression is a flat affect, Mosley wanted to investigate whether the condition could be gauged by observing emotional responses, or lack thereof, in depressive patients.
Their study involved 70 patients with depression: 30 with melancholic depression and 40 with non-melancholic depression. These patients were shown two videos, a funny video of a comedian's set carefully edited to remove offensive material (Ricky Gervais' Animals, for the curious), and a short film about a traveling circus called The Butterfly Circus that, Mosley said, is "quite moving" and elicits a lot of brain activity.
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