Change in symptomatology of melancholic depression over two decades. Core symptoms and culturally determined symptoms.

The psychopathology of 183 patients with melancholic depression first admitted to our department in 1969 and 1970 was compared with that of 184 patients first admitted in 1989 and 1990. A multivariate statistical analysis was performed. The main results were as follows: A socioculturally invariable core syndrome of melancholia comprising psychomotor inhibition and vegetative disturbances can be identified. The contents of depressive thinking are, at least in part, culturally determined and vary with value changes in society. Paralleles to social change could be shown in particular for feelings of guilt and a concern with self-realization.