Results of the DSM-IV Mood Disorders Field Trial

Published on Jan 1, 1995in American Journal of Psychiatry 13.40
· DOI :10.1176/ajp.152.6.843
Martin B. Keller113
Estimated H-index: 113
(Butler Hospital),
Daniel N. Klein71
Estimated H-index: 71
(Butler Hospital)
+ 8 AuthorsT. Shea1
Estimated H-index: 1
(Butler Hospital)
Objective: The DSM-IV mood disorders field trial, a multisite collaborative study, was designed to explore the reliability of a course-based diagnostic classification system for major depression, evaluate the symptom criteria for dysthymia, and explore the need for additional diagnostic categories for milder forms of mood disorder (e.g., minor and recurrent brief depression). Method : Five hundred twenty-four depressed subjects were recruited from inpatient, outpatient, and community settings at five sites and evaluated with structured interviews according to DSM-III and DSM-III-R criteria, with careful attention to longitudinal course. Within- and across-site interrater reliability studies and 6-month test-retest reliability studies were also conducted on subsets of the sample. Results : For evaluations of major depression and dysthymia, intrasite reliability was good to excellent and intersite reliability was fair to good ; 6-month test-retest reliability was fair for dysthymia and poor to fair for major depression. Interrater reliability for six course of illness specifiers was fair to good, and almost all subjects could be assigned to a specific type of course. Conclusions : The results supported the use of course-based classification system for major depression. They also suggested that the content validity of the DSM-III-R symptom criteria for dysthymia could be improved by emphasizing cognitive and social/motivational symptoms, although such changes are unlikely to sharpen the distinction between dysthymia and major depression. Finally, 91% of the subjects met the criteria for current or lifetime major depression or dysthymia, suggesting that additional categories for milder forms of depression are not needed.
  • References (14)
  • Citations (196)
Published on Jun 1, 1983in American Journal of Psychiatry 13.40
Martin B. Keller113
Estimated H-index: 113
Phillip Lavori6
Estimated H-index: 6
+ 2 AuthorsGerald L. Klerman73
Estimated H-index: 73
Of 3 1 6 patients with a major depressive disorder who were followed for between 6 months and 2 years, 80 (25%) had a preexisting chronic minor depression of at least 2 years’ duration. The chronic minor depression reduced the apparent effect of the known predictors of recovery and relapse from the major depressive disorder and predicted a very pernicious course for the chronic depression. Furthermore, the longer the patient continued to suffer from a chronic minor depression after recovering fr...
200 Citations Source Cite
Published on Feb 1, 1987in Archives of General Psychiatry
Michael Von Korff114
Estimated H-index: 114
(Group Health Cooperative),
Sam Shapiro43
Estimated H-index: 43
(Johns Hopkins University)
+ 5 AuthorsBarbara J. Burns69
Estimated H-index: 69
(National Institutes of Health)
• Over one half of all persons seen in a primary care clinic were identified as having anxiety or depressive disorder by the primary care provider, the General Health Questionnaire (GHQ), or the Diagnostic Interview Schedule (DIS). In only about 5% of all patients were findings positive on all three assessments concurrently. Both the GHQ and the practitioners identified over 30% of all patients as having a disorder, while about 8% had one or more of five DIS anxiety or depressive disorders (majo...
315 Citations Source Cite
Published on Dec 1, 1988in British Journal of Psychiatry 5.87
Alan S. Lee8
Estimated H-index: 8
Eighty-nine consecutive admissions with primary depressive illness were prospectively ascertained and diagnosed in 1965-66 by R. E. Kendell, who also allocated each a position on a neurotic-psychotic continuum on the basis of previous discriminant function analysis. In 1983-84, 94% of the survivors were personally interviewed by a psychiatrist blind to index admission data. Operational outcome criteria were employed and longitudinal data were established for 98% of the series. Mortality risk was...
250 Citations Source Cite
Published on Feb 1, 1985in Acta Psychiatrica Scandinavica 4.98
Peter Roy-Byrne1
Estimated H-index: 1
Robert M. Post1
Estimated H-index: 1
+ 2 AuthorsDebra Davis1
Estimated H-index: 1
293 Citations Source Cite
Published on Jan 1, 1991in British Journal of Psychiatry 5.87
Declan G M Murphy D G M73
Estimated H-index: 73
(King's College London)
10 Citations Source Cite
Published on Jun 1, 1978in Archives of General Psychiatry
Robert L. Spitzer82
Estimated H-index: 82
Jean Endicott94
Estimated H-index: 94
Eli Robins48
Estimated H-index: 48
• A crucial problem in psychiatry, affecting clinical work as well as research, is the generally low reliability of current psychiatric diagnostic procedures. This article describes the development and initial reliability studies of a set of specific diagnostic criteria for a selected group of functional psychiatric disorders, the Research Diagnostic Criteria (RDC). The RDC are being widely used to study a variety of research issues, particularly those related to genetics, psychobiology of selec...
5,455 Citations Source Cite
Published on Jun 1, 1990in Journal of Affective Disorders 3.79
Jules Angst77
Estimated H-index: 77
Kathleen R. Merikangas100
Estimated H-index: 100
+ 1 AuthorsW. Wicki1
Estimated H-index: 1
(Yale University)
Abstract This paper presents the diagnostic criteria for a new subtype of affective disorder, recurrent brief depression (RBD). Data from a prospective longitudinal cohort of young adults from the general population of Zurich, Switzerland, showed that a substantial proportion, met all of the criteria for major depression in current diagnostic systems except duration. The validity of the subtype of RBD was examined according to clinical manifestations, severity, longitudinal course, and family hi...
166 Citations Source Cite
Published on Sep 1, 1981in American journal of mental deficiency
Domenic V. Cicchetti60
Estimated H-index: 60
Sara A. Sparrow1
Estimated H-index: 1
Abstract A set of criteria based upon biostatistical considerations for determining the interrater reliability of specific adaptive behavior items in a given setting was presented. The advantages and limitations of extant statistical assessment procedures were discussed. Also, a set of guidelines for differentiating type of adaptive behavior that are statistically reliable from those that are reliable in a clinical or practical sense was delineated. Data sets were presented throughout in order t...
1,226 Citations
Published on Oct 1, 1992in Archives of General Psychiatry
Kenneth B. Wells83
Estimated H-index: 83
M. Audrey Burnam53
Estimated H-index: 53
+ 2 AuthorsPatti Camp7
Estimated H-index: 7
• Objective.— To compare the course of depression during a 2-year period in adult outpatients (n=626) with current major depression, dysthymia, and either both current disorders ("double depression") or depressive symptoms with no current depressive disorder. Methods.— Depressed patients visiting 523 clinicians (mental health specialists and general medical providers) were identified using a two-stage screening procedure including the Diagnostic Interview Schedule. The course of depression was a...
402 Citations Source Cite
Cited By196
Published on Aug 1, 1998in Clinical Psychology Review 9.58
Steven K. Huprich21
Estimated H-index: 21
(University of North Carolina at Chapel Hill)
Abstract This article reviews the theoretical construct of depressive personality disorder and its related research. The history of depressive personality disorder is reviewed. It is concluded that differing theories converge on similar descriptions and mechanisms of development for the depressive personality disorder. Substantial empirical work supports the diagnostic distinctiveness of depressive personality disorder in clinical populations. Past and current assessment devices for assessing de...
63 Citations Source Cite
Published on Dec 1, 2002in Journal of Contemporary Psychotherapy
Carla A. DiSalvo2
Estimated H-index: 2
(Virginia Commonwealth University),
P James McCulloughJr.2
Estimated H-index: 2
(Virginia Commonwealth University)
A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition perfor...
3 Citations Source Cite
Published on Apr 1, 1997in Journal of Contemporary Psychotherapy
Steven K. Huprich21
Estimated H-index: 21
Mark A. Fine34
Estimated H-index: 34
(University of Missouri)
In this article, we discuss the DSM-III-R self-defeating personality disorder and the DSM-IV depressive personality disorder. Descriptions of and empirical studies on the DSM conceptualizations of these two disorders are provided, along with descriptions from various theoretical perspectives. Although these two disorders have not been formally recognized in the diagnostic nomenclature, clinical descriptions and empirical findings suggest that consideration of treatment strategies for these disor...
5 Citations Source Cite
Published on Oct 10, 2003
Anne Garland14
Estimated H-index: 14
About the Authors. Preface. Acknowledgements. Introduction The Challenge of Persistent Depression. Chapter 1 The Cognitive Model of Persistent Depression. Chapter 2 The Foundations of Therapy: Therapeutic Relationship, Style and Structure. Chapter 3 Initial Assessment and Formulation. Chapter 4 Initiating Therapy: Socialisation and Setting Goals. Chapter 5 Using Standard Behavioural Techniques. Chapter 6 Working With Automatic Thoughts. Chapter 7 Recognising Underlying Beliefs and Their Effects....
39 Citations
Published on Aug 1, 2007in Nervenarzt 0.74
U. Schweiger1
Estimated H-index: 1
V. Sipos1
Estimated H-index: 1
+ 2 AuthorsFritz Hohagen41
Estimated H-index: 41
Patienten mit chronischer Depression sind aufgrund ihrer Krankheitsschwere und Therapieresistenz eine Problemgruppe. Sie weisen eine erhohte Komorbiditat mit psychischen und medizinischen Storungen auf, berichten vermehrt uber ungunstige Entwicklungsbedingungen in ihrer Kindheit, zeigen problematische interpersonelle Verhaltensweisen und unterscheiden sich in ihrem Denken von Gesunden durch strukturelle Besonderheiten. Aus diesem Grund wurden in den letzten Jahren eine Reihe von spezifischen The...
2 Citations Source Cite
Published on Jun 1, 2014in Depression and Anxiety 5.04
Rudolf Uher61
Estimated H-index: 61
(Dalhousie University),
Jennifer L. Payne25
Estimated H-index: 25
(Johns Hopkins University)
+ 1 AuthorsRoy H. Perlis64
Estimated H-index: 64
(Harvard University)
The changes in diagnostic criteria for major depressive disorder (MDD) from the fourth to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) may appear small but have important consequences for how the diagnosis is used. In DSM-5, MDD is part of the new “Depressive disorders” section, which is separate from “Bipolar disorders”, marking a division in what had been known as “Mood disorders”. A small wording change has expanded the core mood criterion to include ho...
75 Citations Source Cite
Published on Jan 1, 2002in Revista De Psiquiatria Clinica
Michael Bauer69
Estimated H-index: 69
Peter C. Whybrow39
Estimated H-index: 39
+ 2 AuthorsH.-J. Möller97
Estimated H-index: 97
These practice guidelines for the biological treatment of unipolar depressive disorders were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal for developing these guidelines was to systematically review all available evidence pertaining to the treatment of the complete spectrum of unipolar depressive disorders, and to produce a series of practice recommendations that are clinically and scientifically meaningful based on the ...
101 Citations Source Cite
Pia Ley5
Estimated H-index: 5
Sylvia Helbig-Lang8
Estimated H-index: 8
Franz Petermann44
Estimated H-index: 44
Chronische Depression gilt in der klinischen Praxis als besonders schwer behandelbar. Die Befundlage zu dieser Annahme ist jedoch unbefriedigend. Die wenigen existierenden Effektivitatsstudien zu verschiedenen Formen von Psychotherapie bei chronischen Depressionen (z. B. KVT, IPT, CBASP) zeigen tatsachlich, dass die Wirksamkeit eines rein psychotherapeutischen Vorgehens bei chronischen Depressionen begrenzt zu sein scheint; es gibt jedoch Hinweise auf additive Effekte im Rahmen einer Kombination...
6 Citations Source Cite
Published on Jul 8, 1996in Journal of Affective Disorders 3.79
Gianfranco Spalletta52
Estimated H-index: 52
(University of Rome Tor Vergata),
Alfonso Troisi35
Estimated H-index: 35
(University of Rome Tor Vergata)
+ 2 AuthorsAugusto Pasini28
Estimated H-index: 28
(University of Rome Tor Vergata)
We assessed the descriptive validity of DSM-III-R major depression (MDD), dysthymia (DD) and adjustment disorder with depressed mood (ADDM) by comparing the clinical profiles of 176 young male patients. The severity of depression increased progressively across the three diagnostic groups (ADDM < DD < MDD). Symptom presentation did not distinguish clearly between the diagnostic groups, even though somatic symptoms were more frequent among MDD patients. The prevalence of personality disorders was ...
26 Citations Source Cite
Published on Apr 1, 1999in British Journal of Psychiatry 5.87
Harold Alan Pincus61
Estimated H-index: 61
(American Psychological Association),
Wendy W. Davis18
Estimated H-index: 18
(American Psychological Association),
Laurie E. McQueen3
Estimated H-index: 3
(American Psychological Association)
BACKGROUND Subthreshold conditions (i.e. not meeting full diagnostic criteria for mental disorders in DSM-IV or ICD-10) are prevalent and associated with significant costs and disability. Observed more in primary care and community populations than in speciality settings, varying conceptualisations have been applied to define these conditions. AIMS To examine definitional issues for subthreshold forms of depression (e.g. minor depression) and to suggest future directions for research and nosolog...
214 Citations Source Cite