This review aims at critically exploring sadness, as a core symptom – an integral part of depression, and proposes to describe its clinical aspects, its links to neurovegetative symptoms, and the pertinence of its use as a target for therapeutics. Sadness is an integral part of definitions and classifications of depression Sadness is considered to be one of the core symptoms of depression by most authors. Its clinical importance for the depressive syndrome has been

attested to by various studies. Among the Inhibitors,research,lifescience,medical arguments for its clinical value is the fact that sadness is present in an increasing number of patients when depression grows in severity, as Beck described in a study in 486 subjects, ranging from nondeprcsscd controls to severely ill patients (Table I).5 Table I Frequency of low mood acording to the severity of depression. Adapted from ref 5: Beck AT. Depression: Clinical, Experimental and Theoretical Aspects. New York, NY: Harper & Row; 1967. Inhibitors,research,lifescience,medical Copyright © Harper and Row 1967 As described by Inhibitors,research,lifescience,medical Beck, sadness is present in a certain number of healthy controls, who do not reach the criteria for depressive disorders; on the

other hand, in selleckchem severe depression, a low mood is present in only 94% of the subjects, which implies that some severely depressed patients do not experience sadness as part of their depressive syndrome. The clinical reliability of sadness for diagnosing depression Inhibitors,research,lifescience,medical could thus be challenged. In developed countries, the medical services available and the decrease in stigmatization should explain the fact that a number of clinical cases of depression arc diagnosed before the illness increases in

severity. These points should lead to Inhibitors,research,lifescience,medical describing and considering each depressive disorder distinctly, using the clinical features of their original description. In the two main classification systems that are currently used, sadness is one of the main symptoms of depression, but this is not enough for the diagnosis. In the International Classification of Diseases, 10th edition, or 17-DMAG (Alvespimycin) HCl ICD-10,6 and in the Diagnostic and Statistical Manual of Mental Disorders, 4th revision (DSM-IV, American Psychiatric Association7), whereas sadness is one of the main depressive symptoms, the diagnosis of major depression can be attributed without the presence of sadness. Currently, the diagnosis of major depressive episode is drawn from the presence of five of various symptoms among nine (weight variation, insomnia, psychomotor agitation or retardation, loss of energy, feelings of worthlessness, diminished concentration, recurrent thoughts of death), which must include depressed mood or lost of interest or pleasure in almost all activities.