{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:43:43Z","timestamp":1790696623414,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"s433","license":[{"start":{"date-parts":[[2007,1,15]],"date-time":"2007-01-15T00:00:00Z","timestamp":1168819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:p><jats:bold>Objective:\u2002<\/jats:bold> We argue for a mixed state core for melancholia comparing concepts of melancholia across centuries using examples from art, history and scientific literature.<\/jats:p><jats:p><jats:bold>Method:\u2002<\/jats:bold> Literature reviews focusing on studies from Kraepelin onward, DSM\u2010IV classification and view\u2010points from clinical experience highlighting phenomenologic and biologic features as predictors of bipolar outcome in prospective studies of depression.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Despite the implied chemical pathology in the term endogenous\/melancholic depression, frequently reported glucocortical and sleep neurophysiologic abnormalities, there is little evidence that melancholia is inherited independently from more broadly defined depressions. Prospective follow\u2010up of \u2018neurotic\u2019 depressions have shown melancholic outcomes in as many as a third; hypomania has also been observed in such follow\u2010up.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> These findings and considerations overall do suggest that melancholia as defined today is more closely aligned with the depressive and\/or mixed phase of bipolar disorder. Given the high suicidality from many of these patients the practice of treating them with antidepressant monotherapy needs re\u2010evaluation.<\/jats:p>","DOI":"10.1111\/j.1600-0447.2007.00962.x","type":"journal-article","created":{"date-parts":[[2007,1,15]],"date-time":"2007-01-15T18:05:40Z","timestamp":1168884340000},"page":"44-49","source":"Crossref","is-referenced-by-count":15,"title":["A mixed state core for melancholia: an exploration in history, art and clinical science"],"prefix":"10.1111","volume":"115","author":[{"given":"H. 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