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University of Pittsburgh School of Medicine, PA, USA. thaseme@msx.upmc.edu
A significant minority of depressed outpatients and a vast majority of those hospitalized for depression can be considered severely ill. Severe depressive states are quite heterogeneous and include the more classical subforms (e.g., melancholia or psychotic depression) as well as various comorbid presentations. This article reviews the classification, phenomenology, pathophysiology, and treatment of severe depression.
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