Severe depression

Melancholy is the most intense and most severe form of depression. His clinical depressive syndrome differs from that has just been described by three key elements:

mental pain than physical pain, divestment is global and massive, slow the engine approaches linhibition,

expression of delusional ideas often reluctantly always centered on themes of worthlessness, déchec, guilt, or ruin dincurabilité,

constant desire for death, sometimes verbalized, often with great reluctance: only its inhibition prevents moving subject to the achievement of the notice suicidal.

Any melancholy life-threatening. The risk of suicide should be evaluated in all depressed patients, asking them directly about their suicidal thoughts and impulses as well as their personal history of suicide attempts.

Clinical forms

The clinic episode determines the specifics of melancholy access:

single melancholic depression: intensity of grief, the importance of anhedonia, psychomotor retardation and somatic symptoms, presence of delusions (guilt, worthlessness)

delirious melancholy major depressive episode associated with delirium near the simple melancholic depression plus the notion of persecution,

anxious melancholy anxiety marked hypersthésie painful agitation (disturbing diagnosis), moral pain and severe anhedonia, lack of reaction with the environment, sense of guilt, unworthiness,

stupor melancholy maximum psychomotor inhibition, often involved in bipolar disorder,

mood disorder masked by somatic symptoms which the patient refers (physical ailments:: digestive disorders, cardio-respiratory and varied and persistent pain such as headaches, pains of facial area, back pain). masked depression Multiple somatization and anxiety sensations conceal depressive syndrome making diagnosis difficult.