to stay or to leave? group A had partners with initial IBM care scores of 20 or more group B & C rated their partners at less than 20 for IBM care group B separated from their partners while group C didn’t C depr’n score A B Hickie I et al The impact of an uncaring partner on improvement in non-melancholic depression J Affect Dis 1992;25:147-60 weeks

features of “melancholia” A. either of the following, occurring during the most severe period of the current episode: 1.) loss of pleasure in all, or almost all, activities 2.) lack of reactivity to usually pleasurable stimuli (does not feel much better even temporarily, when something good happens) 1.) distinct quality of depressed mood (i.e. the depressed mood is experienced as dist-inctly different from the kind of feeling experienced after the death of a loved one) 2.) depression regularly worse in the morning 3.) early morning awakening (at least two hours earlier than the usual time of awakening) 4.) marked psychomotor retardation or agitation 5.) significant anorexia or weight loss 6.) excessive or inappropriate guilt B. three (or more) of the following: note there are numerous qualifiers etc. dysthymia requires that for a 2 year period 1.) depressive mood is present during most of the day, for more days than not. this includes two or more of: a) poor appetite or overeating b) insomnia or hypersomnia c) low energy or fatigue d) low self-esteem f) poor concentration or difficulty making decisions g) feelings of hopelessness 2.) depressive symptoms are never absent for more than two months 3.) no major depressive episode occurs during the first two years of the disorder American Psychiatric Association Diagnostic & statistical manual of mental disorders (4th ed) Washington DC: American Psychiatric Press, 1994