Classification of Depressive Disorders in the DSM-V : Proposal for a Two-Dimension System

Published on Jan 1, 2008in Journal of Abnormal Psychology 4.64
· DOI :10.1037/0021-843X.117.3.552
Daniel N. Klein71
Estimated H-index: 71
(Stony Brook University)
Abstract
The number of categories and specifiers for mood disorders has increased with each successive edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM). Many of these categories and specifiers can be viewed as an effort to map the various permutations of severity and chronicity that characterize the depressive disorders. However, this has resulted in a system that (a) is unnecessarily complex and unwieldy, (b) has created problems with artificial distinctions between categories and artifactual comorbidity, and (c) at the same time obscures what may be more fundamental distinctions. A potentially useful and more parsimonious approach to capturing much of the heterogeneity of depressive disorders is to classify the depressive disorders along 2 dimensions, 1 reflecting severity and the other, chronicity. Considerations in the development of these dimensions are discussed, and a set of examples is presented. Although further research and discussion are needed to determine the optimal form of these dimensions, the next edition of the DSM should consider replacing many of the existing categories and specifiers for depressive disorders with the simpler approach of classifying depressive disorders using the 2 dimensions of severity and chronicity.
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References87
Published on Jul 1, 2002in Clinical Psychology Review 9.58
Kate E. Hamilton2
Estimated H-index: 2
(University of Calgary),
Keith S. Dobson41
Estimated H-index: 41
(University of Calgary)
Abstract This review examines the role of patient predictors of outcome in cognitive therapy of depression. Studies that meet eligibility criteria are reviewed for demonstrated linkage between various predictors (i.e., pretreatment severity, historical features, demographic predictors, dysfunctional attitudes and other cognitive features, and treatment acceptability) and outcome, and several effects are found. Notably, high pretreatment severity scores are associated with poorer response to cogn...
6,175 Citations Source Cite
Published on Jan 1, 1997in Psychopharmacology Bulletin
Harry E. Gwirtsman31
Estimated H-index: 31
,
Blehar Mc1
Estimated H-index: 1
+ 2 AuthorsPrien Rf1
Estimated H-index: 1
26 Citations
Published on Feb 1, 1996in American Journal of Psychiatry 13.40
Carina Vocisano5
Estimated H-index: 5
,
Daniel N. Klein71
Estimated H-index: 71
+ 2 AuthorsM. M. Kincaid1
Estimated H-index: 1
Objective : This exploratory study examined the characteristics of a group of unusual and previously undescribed patients with major affective disorder who not only had been continuously symptomatic for prolonged periods of time but were also so functionally impaired that they required years of continuous care in psychiatric facilities or by family members. Method : Twenty-seven inpatients with major mood disorders and 29 inpatients with schizophrenia were recruited from a large state hospital ;...
41 Citations Source Cite
Published on Apr 1, 2002in Journal of General Internal Medicine 4.00
Ronald T. Ackermann30
Estimated H-index: 30
(University of Washington),
John W Williams66
Estimated H-index: 66
(Duke University)
OBJECTIVE: This review synthesizes available evidence for managing clinically significant dysphoric symptoms encountered in primary care, when formal criteria for major depression or dysthymia are not met. Discussion is focused on premenstrual dysphoric disorder (PMDD) and minor depression because of their significant prevalence in the primary care setting and the lack of clear practice guidelines for addressing each illness.
58 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
Published on Jan 1, 2004in Journal of Abnormal Psychology 4.64
John Ruscio J30
Estimated H-index: 30
(Elizabethtown College),
Ayelet Meron Ruscio38
Estimated H-index: 38
(Pennsylvania State University),
Terence M. Keane57
Estimated H-index: 57
(Boston University)
Joining the debate on the structure of depression, S. R. H. Beach and N. Amir (2003) analyzed college students' responses to 6 Beck Depression Inventory (BDI) items with predominantly somatic content and concluded that they identified a small latent taxon corresponding to involuntary defeat syndrome. An exact replication of these analyses yielded virtually identical taxometric results, but parallel analyses of simulated taxonic and dimensional comparison data matching the intercorrelations and s...
84 Citations Source Cite
Published on Nov 1, 2002in Comprehensive Psychiatry 2.13
Stewart A. Shankman23
Estimated H-index: 23
(Stony Brook University),
Daniel N. Klein71
Estimated H-index: 71
(Stony Brook University)
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...
17 Citations Source Cite
Published on Mar 1, 2000in Comprehensive Psychiatry 2.13
Jules Angst77
Estimated H-index: 77
,
Robert Sellar1
Estimated H-index: 1
,
Kathleen R. Merikangas100
Estimated H-index: 100
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...
119 Citations Source Cite
Published on Jun 15, 2004in The Journal of Clinical Psychiatry 4.25
Tarja Melartin26
Estimated H-index: 26
,
Heikki Rytsälä23
Estimated H-index: 23
+ 3 AuthorsErkki Isometsä60
Estimated H-index: 60
Background: Information on the naturalistic outcome of major depressive disorder (MDD) is important in developing rational clinical practices. The aim of this study was to determine the outcome of MDD in a modern secondary-level psychiatric setting and the influence of comorbidity plus psychosocial factors on the outcome of MDD. Method: The Vantaa Depression Study is a prospective, naturalistic cohort study of 269 secondary-level care psychiatric outpatients and inpatients diagnosed with a new e...
119 Citations Source Cite
Cited By69
Published on Jul 3, 2015in Psychological Inquiry 26.36
Daniel N. Klein71
Estimated H-index: 71
(Stony Brook University),
Greg Hajcak62
Estimated H-index: 62
(Stony Brook University)
4 Citations Source Cite
Published on Jan 1, 2015in Psychotherapy and Psychosomatics 13.12
Elisabeth Schramm26
Estimated H-index: 26
,
Ingo Zobel11
Estimated H-index: 11
+ 8 AuthorsMathias Berger41
Estimated H-index: 41
Background: A specific psychotherapy for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), was compared to escitalopram (ESC)
17 Citations Source Cite
Published on Jul 1, 2014in European Journal of Personality 3.49
C. Emily Durbin27
Estimated H-index: 27
(Michigan State University),
Brian M. Hicks39
Estimated H-index: 39
(University of Michigan)
A dominant paradigm in psychopathology research proposes that individual differences in personality are centrally involved in the origins and manifestations of psychopathology, and structural models of personality and psychopathology have been extremely useful in helping to organize associations among many traits and disorders. However, these models merely describe patterns of covariation; they do not explain the processes by which these patterns emerge. We argue that the field is stagnated, as ...
42 Citations Source Cite
Published on Dec 1, 2012in Journal of Affective Disorders 3.79
Annette van Randenborgh5
Estimated H-index: 5
,
Joachim Hüffmeier13
Estimated H-index: 13
(University of Münster)
+ 3 AuthorsMarkus Pawelzik3
Estimated H-index: 3
Abstract Background The specific features that differentiate chronic and episodic depression are widely unknown. This study compares the chronic and episodic form of depression with regard to two domains of socio-emotional information processing: Decoding of other people's emotional states (Theory of Mind) and the perception of own emotions (alexithymia). Method This study compares 30 chronically and 29 episodically depressed patients by tapping into Theory of Mind deficits with a multi-method a...
33 Citations Source Cite
Published on Jan 1, 2013in Clinical psychological science
Paul Rohde66
Estimated H-index: 66
(Oregon Research Institute),
Peter M. Lewinsohn94
Estimated H-index: 94
(Oregon Research Institute)
+ 2 AuthorsJeff M. Gau21
Estimated H-index: 21
(Oregon Research Institute)
This article summarizes characteristics of major depressive disorder (MDD) in the Oregon Adolescent Depression Project, using data from 816 participants (56% female; 89% White). Contrasting four developmental periods (childhood, 5.0–12.9 years of age; adolescence, 13.0–17.9; emerging adulthood, 18.0–23.9; adulthood, 24–30), we examine MDD incidence/recurrence, gender, comorbidity, duration, and suicide attempts across periods. MDD first incidence was lower in childhood compared to subsequent per...
115 Citations Source Cite
Published on Jan 1, 2011in Psychological Assessment 3.37
Christina M. Mitchell3
Estimated H-index: 3
(Colorado School of Public Health),
Janette Beals39
Estimated H-index: 39
(Colorado School of Public Health)
The Kessler Screening Scale for Psychological Distress (K6) has been used widely as a screener for mental health problems and as a measure of severity of impact of mental health problems. However, the applicability and utility of this measure for assessments within American Indian communities has not been explored. Data were drawn from a large-scale epidemiological study conducted in cooperation with two American Indian populations. Participants (n = 3,084) were 15 – 54 years old, living on or n...
37 Citations Source Cite
Published on Mar 1, 2009in Psychological Medicine 5.47
Jeremy W. Pettit30
Estimated H-index: 30
(University of Houston),
Peter M. Lewinsohn94
Estimated H-index: 94
(Oregon Research Institute)
+ 2 AuthorsL. Monteith1
Estimated H-index: 1
(University of Houston)
Background Research on the long-term course of major depressive disorder (MDD) is hindered by the absence of established course criteria and by idiosyncratic definitions of chronicity. The aims of this study were to derive an empirical index of MDD course, to examine its predictive validity, and to identify the adulthood outcomes associated with a chronic course.
33 Citations Source Cite
Published on Jun 1, 2009in Clinical Psychology-science and Practice 4.95
Eric A. Youngstrom58
Estimated H-index: 58
(University of North Carolina at Chapel Hill)
This article reviews the current diagnostic criteria for bipolar mood episodes and disorders, emphasizing gaps and limitations in the current definitions. The review also discusses terms that have been perceived as inconsistent between child versus adult presentations of bipolar disorders, such as “rapid cycling.” The review links the DSM diagnoses to broader discussions of a bipolar spectrum, and to alternate definitions of “narrow,”“intermediate,” and “broad” phenotypes. Strengths and limitati...
32 Citations Source Cite
Published on Nov 1, 2014in NeuroImage 5.43
Dan Foti25
Estimated H-index: 25
(Purdue University),
Joshua M. Carlson19
Estimated H-index: 19
(Northern Michigan University)
+ 1 AuthorsGreg Hajcak Proudfit22
Estimated H-index: 22
(Stony Brook University)
Abstract Reward dysfunction is thought to play a core role in the pathophysiology of major depressive disorder (MDD). Event-related potential (ERP) and functional magnetic resonance imaging (fMRI) studies have identified reward processing deficits in MDD, but these methods have yet to be applied together in a single MDD sample. We utilized multimodal neuroimaging evidence to examine reward dysfunction in MDD. Further, we explored how neurobiological reward dysfunction would map onto subtypes of ...
68 Citations Source Cite
Published on Sep 1, 2012in Health Psychology Review 8.60
Jonathan A. Shaffer15
Estimated H-index: 15
(Columbia University Medical Center),
William Whang24
Estimated H-index: 24
(Columbia University Medical Center)
+ 3 AuthorsKarina W. Davidson21
Estimated H-index: 21
(Columbia University Medical Center)
Although research has consistently established that depression and elevated depressive symptoms are associated with an increased risk of acute coronary syndrome (ACS) recurrence and mortality, clinical trials have failed to show that conventional depression interventions offset this risk. As depression is a complex and heterogeneous syndrome, we believe that using simpler, or intermediary, phenotypes rather than one complex phenotype may allow better identification of those at particular risk of...
9 Citations Source Cite