scinapse is loading now...

Dimensional diagnosis of depression: Adding the dimension of course to severity, and comparison to the DSM

Published on Nov 1, 2002in Comprehensive Psychiatry 2.13
· DOI :10.1053/comp.2002.35902
Stewart A. Shankman24
Estimated H-index: 24
(Stony Brook University),
Daniel N. Klein72
Estimated H-index: 72
(Stony Brook University)
Abstract
Abstract It has long been debated whether depression is best classified with a categorical or dimensional diagnostic system. There has been surprisingly little discussion, however, of what the contents of a dimensional classification should include, with most studies employing a single dimension based on symptom severity. The present study explored whether a dimension based on prior course of depression increases the validity of a dimensional model based on symptom severity alone and whether the two dimensions combined improve upon the present categorical system (DSM). The sample consisted of 133 patients with a broad spectrum of depressive diagnoses. External validators included family history of mood disorder, assessed using the family history method, and course over a 6-month prospective follow-up period. Prior course contributed significant incremental validity over and above symptom severity in predicting subsequent course and family history of mood disorder. However, the linear combination of symptom severity and prior course provided only a minimal increase in predictive power over and above the DSM diagnoses of major depressive disorder (MDD) and dysthymia. Copyright 2002, Elsevier Science (USA). All rights reserved.
  • References (52)
  • Citations (17)
Cite
References52
Newest
Published on Nov 13, 2007in Acta Psychiatrica Scandinavica 4.98
G. Garyfallos4
Estimated H-index: 4
(Northwestern University),
A. Adarnopoulou1
Estimated H-index: 1
(Northwestern University)
+ 5 AuthorsA. Paraschos1
Estimated H-index: 1
Objective: The purpose of the present study was to investigate the comorbidity of personality disorders in patients with primary dysthymia compared to those with episodic major depression. Method: A total of 177 out-patients with primary dysthymia and 187 outpatients with episodic major depression were administered a structured diagnostic interview for DSM-III-R Axis II disorders. In addition, all of these patients completed the BDI, and those with the appropriate level of education also complet...
45 Citations Source Cite
Published on Aug 1, 2001in Journal of Nervous and Mental Disease 1.94
Ari Solomon12
Estimated H-index: 12
,
David A. F. Haaga33
Estimated H-index: 33
,
Bruce A. Arnow45
Estimated H-index: 45
Resolving whether subthreshold depressive symptoms exist on a continuum with unipolar clinical depression is important for progress on both theoretical and applied issues. To date, most studies have found that individuals with subthreshold depressive symptoms resemble cases of major depressive disorder along many important dimensions (e.g., in terms of patterns of functional impairment, psychiatric and physical comorbidity, familiality, sleeping EEG, and risk of future major depression). However...
130 Citations Source Cite
Published on Aug 1, 2000in American Journal of Psychiatry 13.40
Gordon Parker81
Estimated H-index: 81
OBJECTIVE: Classification of the depressive disorders has long been controversial. The dominant current model is unitarian, with disorders largely distinguished on the basis of severity. Both the unitarian and the contrasting binarian views (of two principal types) have proved to be unsatisfactory. The binarian model’s procrustean requirements are too inflexible to address the evident heterogeneity contributed to by clinical manifestations and underlying personality features. METHOD: This articl...
229 Citations Source Cite
Published on Jul 1, 2000in Journal of Affective Disorders 3.79
Li Shiun Chen8
Estimated H-index: 8
(Johns Hopkins University),
William W. Eaton82
Estimated H-index: 82
(Johns Hopkins University)
+ 1 AuthorsGerald Nestadt65
Estimated H-index: 65
(Johns Hopkins University)
Background: There is an ongoing research effort to test if depression is a homogeneous clinical syndrome and to identify valid and useful subtypes based on the number and nature of depressive symptoms. This study summarizes the patterns of depressive symptoms evident in a prospective study of the general population and examines the validity of potential subtypes by studying their course and etiologic heterogeneity. Methods: A general population sample of 1920 adults (aged 18-96) from the Baltimo...
112 Citations Source Cite
Published on Jun 1, 2000in American Journal of Psychiatry 13.40
Daniel N. Klein72
Estimated H-index: 72
,
Joseph E. Schwartz91
Estimated H-index: 91
+ 1 AuthorsJulie B. Leader5
Estimated H-index: 5
OBJECTIVE: There have been few naturalistic follow-up studies of dysthymic disorder. This study describes the 5-year course and outcome of dysthymic disorder.METHOD: The authors conducted a prospective, longitudinal follow-up study of 86 outpatients with early-onset dysthymic disorder and 39 outpatients with episodic major depressive disorder. Follow-ups, conducted 30 and 60 months after entry into the study, rated patients on the Longitudinal Interval Follow-Up Evaluation and the Modified Hamil...
138 Citations Source Cite
Published on Mar 1, 2000in Comprehensive Psychiatry 2.13
Jules Angst81
Estimated H-index: 81
,
Robert Sellar1
Estimated H-index: 1
,
Kathleen R. Merikangas102
Estimated H-index: 102
There has been widespread debate about the validity of the contemporary diagnostic classification system of depression. The major goal of this study is to examine the prognostic significance of each of the major subtypes of depression using data from 5 interviews of a 15-year prospective community-based cohort study. The stability of the following diagnostic subtypes across the duration of the study was examined: major depressive disorder (MDD), dysthymia, recurrent brief depression (RBD), and m...
118 Citations Source Cite
Published on Jan 1, 2000in Journal of Abnormal Psychology 4.64
Peter M. Lewinsohn94
Estimated H-index: 94
(Oregon Research Institute),
Ari Solomon12
Estimated H-index: 12
(Stanford University)
+ 1 AuthorsAntonette M. Zeiss28
Estimated H-index: 28
There is active debate regarding whether diagnosable depression exists on a continuum with subthreshold depressive symptoms or represents a categorically distinct phenomenon. To address this question, multiple indexes of dysfunction (psychosocial difficulties, mental health treatment history, and future incidence of major depression and substance abuse/dependence) were examined as a function of the extent of depressive symptoms in 3 large community samples (adolescent, adult, and older adult; N ...
364 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. McQueen4
Estimated H-index: 4
(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
Published on Apr 1, 1999in Archives of General Psychiatry
Kenneth S. Kendler152
Estimated H-index: 152
,
Charles O. Gardner42
Estimated H-index: 42
,
Carol A. Prescott64
Estimated H-index: 64
Background Major depression (MD) is both clinically and etiologically heterogeneous. We attempt to relate clinical and etiologic heterogeneity by determining those features of MD that reflect a high familial liability to depressive illness. Methods Our sample, 3786 personally interviewed twin pairs from a population-based registry, contained 1765 people with a lifetime history of MD by DSM-III-R criteria, of whom 639 (36.2%) had affected co-twins. We examine, using Cox proportional hazard models...
116 Citations Source Cite
Published on Oct 1, 1998in Archives of General Psychiatry
W. John Livesley43
Estimated H-index: 43
,
Kerry L. Jang35
Estimated H-index: 35
,
Philip A. Vernon47
Estimated H-index: 47
Background The evidence suggests that personality traits are hierarchically organized with more specific or lower-order traits combining to form more generalized higher-order traits. Agreement exists across studies regarding the lower-order traits that delineate personality disorder but not the higher-order traits. This study seeks to identify the higher-order structure of personality disorder by examining the phenotypic and genetic structures underlying lower-order traits. Methods Eighteen lowe...
459 Citations Source Cite
Cited By17
Newest
Stewart A. Shankman24
Estimated H-index: 24
(University of Illinois at Chicago),
Carter J. Funkhouser3
Estimated H-index: 3
(University of Illinois at Chicago)
+ 3 AuthorsDanelle Hee2
Estimated H-index: 2
(University of Illinois at Chicago)
This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test–retest reliability, and concurrent and predictive validity) than categorical diagnoses. Participants (N = 234) were r...
7 Citations Source Cite
Published on May 1, 2017in Research Policy 4.66
Katia Levecque16
Estimated H-index: 16
(Ghent University),
Frederik Anseel21
Estimated H-index: 21
(Ghent University)
+ 2 AuthorsLydia Gisle7
Estimated H-index: 7
Research policy observers are increasingly concerned about the potential impact of current academic working conditions on mental health, particularly in PhD students. The aim of the current study is threefold. First, we assess the prevalence of mental health problems in a representative sample of PhD students in Flanders, Belgium (N = 3659). Second, we compare PhD students to three other samples: (1) highly educated in the general population (N = 769); (2) highly educated employees (N = 592); an...
52 Citations Source Cite
Published on Jun 1, 2014in Journal of Anxiety Disorders 3.48
Nicholas C. Jacobson7
Estimated H-index: 7
(Pennsylvania State University),
Michelle G. Newman38
Estimated H-index: 38
(Pennsylvania State University)
a b s t r a c t Anxiety and depression are often highly correlated with each other. To explain this connection, the present study examined the longitudinal relationship between earlier anxiety and later depression, using avoidance as a mediator and trauma as a moderator. Participants (N = 6504 adolescents) completed baseline measures of anxiety and depression, a measure of avoidance one year later, a measure of trauma six to eight years later, and a measure of depression 12–14 years later. Analy...
35 Citations Source Cite
Published on May 1, 2013in Annals of Clinical Psychiatry 1.47
Leonardo Zaninotto11
Estimated H-index: 11
,
Daniel Souery45
Estimated H-index: 45
+ 7 AuthorsAlessandro Serretti66
Estimated H-index: 66
BACKGROUND: Depressive subtypes generally have been neglected in research on treatment efficacy. We studied a sample of 699 severe unipolar depressed patients to detect any association between depressive features and treatment resistance. METHODS: Participants were divided into psychotic (PSY, n = 90), melancholic (MEL, n = 430) and non-melancholic (n = 179) subjects according to clinical features. Formal diagnostic criteria (Mini International Neuropsychiatric Interview items), and items from 1...
6 Citations
Published on Jul 2, 2012
Christine E. Gould6
Estimated H-index: 6
(West Virginia University),
Barry A. Edelstein and (West Virginia University), Lindsay A. Gerolimatos5
Estimated H-index: 5
(West Virginia University)
Source Cite
Published on Jul 1, 2012in Psychological Medicine 5.47
Didi Rhebergen13
Estimated H-index: 13
(VU University Medical Center),
Femke Lamers25
Estimated H-index: 25
(VU University Medical Center)
+ 3 AuthorsBrenda W. J. H. Penninx126
Estimated H-index: 126
(VU University Medical Center)
Background Current classification of unipolar depression reflects the idea that prognosis is essential. However, do DSM categories of major depressive disorder (MDD), dysthymic disorder (Dysth) and double depression (DD=MDD+Dysth) indeed adequately represent clinically relevant course trajectories of unipolar depression? Our aim was to test DSM categories (MDD, Dysth and DD) in comparison with empirically derived prognostic categories, using a prospectively followed cohort of depressed patients....
42 Citations Source Cite
Candice R Quinn7
Estimated H-index: 7
(University of Sydney),
Anthony Harris43
Estimated H-index: 43
(University of Sydney),
Andrew H. Kemp58
Estimated H-index: 58
(University of Sydney)
Major depressive disorder is often considered to be a homogenous disorder that changes in terms of severity; however, the presence of distinct subtypes and a variety of presenting symptoms suggests much heterogeneity. Aiming to better understand the relationship between heterogeneity and diagnosis we used an exploratory approach to identify subtypes of depression on the basis of clinical symptoms and neuropsychological performance. Cluster analysis identified two groups of patients distinguished...
20 Citations Source Cite
Published on Sep 1, 2011in International Journal of Law and Psychiatry 1.28
Graham Mellsop17
Estimated H-index: 17
(University of Auckland),
Debra Fraser1
Estimated H-index: 1
(University of Auckland)
+ 1 AuthorsDavid B Menkes17
Estimated H-index: 17
(University of Auckland)
Abstract In considering psychiatric evidence, criminal justice systems make considerable use of labels from official psychiatric classificatory systems. There are legislated requirements for psychological and/or behavioural phenomena to be addressed in legal tests, however medico-legal use of the current categorical diagnostic frameworks which are increasingly complex is difficult to justify. The lack of validity in large domains of the present classificatory systems is now more openly acknowled...
3 Citations Source Cite
Published on Jan 1, 2011
Barry A. Edelstein22
Estimated H-index: 22
(West Virginia University),
Daniel L. Segal30
Estimated H-index: 30
(University of Colorado Colorado Springs)
Publisher Summary motions and personalities are multidimensional constructs that require appropriate measures for each dimension. No single method of assessment is consistently superior to any other in cognitively intact individuals. The psychological assessment of older adults is fraught with multiple age-related factors that contribute to its complexity and resulting challenges. The assessment of emotional and personality disorders has advanced considerably in the past two decades through the ...
11 Citations Source Cite