An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of 'pseudo-melancholia' to capture such instances and provide clinical examples of contributing at-risk scenarios. The author draws on clinical experience to provide exemplars of circumstances most risking a false positive diagnosis of melancholia. Pseudo-melancholia can result from invalid measures of melancholia and from several functional and organic conditions presenting with suggested melancholic features. Recognising high-risk pseudo-melancholia scenarios has the potential to advance a change in diagnostic formulation, provide a more diagnosis-specific intervention and so avert a secondary diagnosis of 'treatment resistant depression'.
Gordon Parker. Pseudo-melancholia. Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. 2020 Jun;28(3):339-341
PMID: 32157900
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