Assessment and treatment of dysthymia. The development of the Cornell dysthymia rating scale

1997 ◽  
Vol 12 (4) ◽  
pp. 190-193 ◽  
Author(s):  
J Cohen

SummaryThe understanding and classification of persistently depressed mood has undergone many changes since the term ‘dysthymia’ was first used nearly 150 years ago. Originally it was applied to both melancholia and mania; later it was applied to depressive personality. The Diagnostic and Statistical Manual (DSM)-III in 1980 and in subsequent updates classified dysthymia as a mood disorder, characterized by a frequently insidious onset and a course that is chronic and unremitting. The assessment of clinical response in the pharmacologic treatment of dysthymia has been more difficult than that for major depression. The Hamilton Rating Scale for Depression, among others, is oriented towards episodic rather than chronic states of depression. A new rating scale, the Cornell Dysthymia Rating Scale, has been developed to better assess milder symptomatology in chronically depressed patients. Early studies suggest its utility, but further validation of the scale is needed in patients with dysthymia and without major depression.

2016 ◽  
Vol 33 (2) ◽  
pp. 127-138 ◽  
Author(s):  
Samantha L. Ward ◽  
Karen A. Sullivan ◽  
Linda Gilmore

Objective: Limited time and resources necessitate the availability of accurate, inexpensive and rapid diagnostic aids for Autism Spectrum Disorder (ASD). The Autistic Behavioural Indicators Instrument (ABII) was developed for this purpose, but its psychometric properties have not yet been fully established. Method: The clinician-rated ABII, the Autism Diagnostic Observation Schedule (ADOS), the Childhood Autism Rating Scale – Second Edition, Standard Version (CARS2-ST), and Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria were individually administered to children with an independent paediatrician DSM-IV-TR or DSM-5 autism spectrum diagnosis, aged 2-6 years (n = 51, Mchildage = 3.6 years). The agreement between each of the measures on autism diagnostic classification was calculated and compared, and the intercorrelation between the instruments examined. Results: There was significant moderate agreement for the classification of autism between the ABII and the DSM-5, and significant fair agreement between the ABII and ADOS and ABII and CARS2-ST. True positive diagnostic classifications were similar across the ABII (n = 47, 92.2%) and ADOS (n = 45, 88.2%), and significantly higher than the CARS2-ST (n = 30, 58.8%). The ABII total scale score was strongly positively correlated with both the ADOS and CARS2-ST total scores. Conclusion: The ABII's test characteristics were comparable to those of established measures, and the intercorrelations between selected measures support its convergent validity. The ABII could be added to the clinician's toolbox as a screening test.


2019 ◽  
pp. 69-82
Author(s):  
J. Paul Fedoroff

Abstract: This chapter provides a brief description of the key diagnostic features of exhibitionistic disorder in addition to a historic review of changes in the criteria in the Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases. This is followed by a review of the differential diagnosis and the ways in which the disorder can take different forms or be confused with other disorders. The recent scientific literature on the disorder is summarized. A description of recommended approaches to the assessment and treatment of this disorder, including differential diagnosis and psychotherapeutic and pharmacologic treatments, is presented.


2006 ◽  
Vol 8 (2) ◽  
pp. 207-215 ◽  

Since the introduction of antidepressants to psychopharmacology in the 1960s, the Hamilton Depression Rating Scale (HAM-D) has been the most frequently used rating scale for depression. When used as a scale for prediction of outcome with antidepressants, the HAM-D, by its total score, has obtained limited use analogous to the Diagnostic and Statistical Manual of Mental Disorders. 4th ed (DSM-IV) diagnosis of major depression. Most research has been devoted to the use of the HAM-D to discriminate between placebo and active drugs or to show dose-response relationship in patients with major depression. An improvement in the total HAM-D score during a drug trial does not, however, in itself qualify the drug as an antidepressant, because the total score is not a sufficient statistic. The problem of statistical versus clinical significance when analyzing placebo-controlled trials, including dose-response relationship, is outlined, with the recommendation to use effect size statistics.


Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


Author(s):  
Kathryn H. Gordon ◽  
Jill M. Holm-Denoma ◽  
Ross D. Crosby ◽  
Stephen A. Wonderlich

The purpose of the chapter is to elucidate the key issues regarding the classification of eating disorders. To this end, a review of nosological research in the area of eating disorders is presented, with a particular focus on empirically based techniques such as taxometric and latent class analysis. This is followed by a section outlining areas of overlap between the current Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) eating disorder categories and their symptoms. Next, eating disorder classification models that are alternatives to the DSM-IV-TR are described and critically examined in light of available empirical data. Finally, areas of controversy and considerations for change in next version of the DSM (i.e., the applicability of DSM criteria to minority groups, children, males; the question of whether clinical categories should be differentiated from research categories) are discussed.


Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.


2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.


2021 ◽  
Vol 8 (1) ◽  
pp. 144-155 ◽  
Author(s):  
Gizem Çakın ◽  
Ignatius Darma Juwono ◽  
Marc N. Potenza ◽  
Attila Szabo

Abstract Background and aims Exercise addiction may be conceptualized as a behavioral addiction in which a person develops an unhealthy obsession with exercise and physical activity. While exercise addiction is not a formally recognized disorder in the Diagnostic and Statistical Manual or the International Classification of Diseases, it has been studied and connected to both personal and situational factors. Perfectionism is a feature that has been strongly linked to exercise addiction. The objective of this systematic literature review, performed by following the PRISMA protocol, was to examine relationships between exercise addiction and perfectionism while also considering the subdimensions of perfectionism in different groups. Methods Three databases (PsycINFO, PubMed/Medline, and SPORTDiscus) were examined. Sixty relevant articles were identified, of which 22 met inclusion criteria. Results The findings substantiate that perfectionism and its dimensions are weakly or moderately related to exercise addiction. This relationship has been observed in adults, adolescents, athletes, and patients with eating disorders. Of the 22 studies examined, only one did not identify an association between perfectionism or its subdomain(s) and exercise addiction. However, in most studies, the common variance between perfectionism and exercise addiction is relatively small, raising questions regarding the clinical relevance of the relationship. Conclusion Perfectionism is related to exercise addiction, but the strength of the relationship varies in different circumstances, which should be examined in future research.


2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.


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