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Diagnosing major depressive disorder X: can the utility of the DSM-IV symptom criteria be improved?
J Nerv Ment Dis. 2006 Dec; 194(12):893-7.JN

Abstract

There are two practical problems with the DSM-IV symptom criteria for major depressive disorder (MDD)--they are somewhat lengthy and therefore difficult to remember, and there are difficulties in applying some of the criteria in patients with comorbid medical illnesses because of symptom nonspecificity. Therefore, in the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we attempted to develop a briefer definition of major depression that is composed entirely of mood and cognitive symptoms. Our goal was to develop an alternative set of diagnostic criteria for major depression that did not include somatic symptoms but would nonetheless demonstrate a high level of concordance with the current DSM-IV definition. We examined several alternative definitions of MDD. After eliminating the somatic criteria from the DSM-IV MDD criteria and adding the symptom "reduced drive," there was a very high level of concordance with DSM-IV classification (95%). This new definition thus offers two advantages over the current DSM-IV definition--it is briefer and it is free of somatic symptoms, thereby making it easier to apply with medically ill patients. We discuss using improvement in the clinical utility, rather than validity of diagnostic criteria, as the basis for making revisions in the nomenclature.

Authors+Show Affiliations

Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA. mzimmerman@lifespan.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17164626

Citation

Zimmerman, Mark, et al. "Diagnosing Major Depressive Disorder X: Can the Utility of the DSM-IV Symptom Criteria Be Improved?" The Journal of Nervous and Mental Disease, vol. 194, no. 12, 2006, pp. 893-7.
Zimmerman M, Chelminski I, McGlinchey JB, et al. Diagnosing major depressive disorder X: can the utility of the DSM-IV symptom criteria be improved? J Nerv Ment Dis. 2006;194(12):893-7.
Zimmerman, M., Chelminski, I., McGlinchey, J. B., & Young, D. (2006). Diagnosing major depressive disorder X: can the utility of the DSM-IV symptom criteria be improved? The Journal of Nervous and Mental Disease, 194(12), 893-7.
Zimmerman M, et al. Diagnosing Major Depressive Disorder X: Can the Utility of the DSM-IV Symptom Criteria Be Improved. J Nerv Ment Dis. 2006;194(12):893-7. PubMed PMID: 17164626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosing major depressive disorder X: can the utility of the DSM-IV symptom criteria be improved? AU - Zimmerman,Mark, AU - Chelminski,Iwona, AU - McGlinchey,Joseph B, AU - Young,Diane, PY - 2006/12/14/pubmed PY - 2007/1/31/medline PY - 2006/12/14/entrez SP - 893 EP - 7 JF - The Journal of nervous and mental disease JO - J Nerv Ment Dis VL - 194 IS - 12 N2 - There are two practical problems with the DSM-IV symptom criteria for major depressive disorder (MDD)--they are somewhat lengthy and therefore difficult to remember, and there are difficulties in applying some of the criteria in patients with comorbid medical illnesses because of symptom nonspecificity. Therefore, in the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we attempted to develop a briefer definition of major depression that is composed entirely of mood and cognitive symptoms. Our goal was to develop an alternative set of diagnostic criteria for major depression that did not include somatic symptoms but would nonetheless demonstrate a high level of concordance with the current DSM-IV definition. We examined several alternative definitions of MDD. After eliminating the somatic criteria from the DSM-IV MDD criteria and adding the symptom "reduced drive," there was a very high level of concordance with DSM-IV classification (95%). This new definition thus offers two advantages over the current DSM-IV definition--it is briefer and it is free of somatic symptoms, thereby making it easier to apply with medically ill patients. We discuss using improvement in the clinical utility, rather than validity of diagnostic criteria, as the basis for making revisions in the nomenclature. SN - 0022-3018 UR - https://www.unboundmedicine.com/medline/citation/17164626/Diagnosing_major_depressive_disorder_X:_can_the_utility_of_the_DSM_IV_symptom_criteria_be_improved L2 - https://doi.org/10.1097/01.nmd.0000248970.50265.34 DB - PRIME DP - Unbound Medicine ER -