Uncomplicated Depression as Normal Sadness

2016 ◽  
pp. 82-94
Author(s):  
Jerome C. Wakefield ◽  
Allan V. Horwitz ◽  
Lorenzo Lorenzo-Luaces
Keyword(s):  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Major Depression ◽  
General Population ◽  
Depressive Disorder ◽  
Generalized Anxiety Disorder ◽  
Research Program ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Depressive Episodes

About half of all individuals meet the criteria for DSM-defined major depressive disorder (MDD) by the age of 30. These and other considerations suggest that MDD criteria are too inclusive and apply to individuals who are not ill but are experiencing normal sadness. This chapter reviews a research program that attempts to address this issue by examining “uncomplicated depression,” a subcategory of MDD that is hypothesized to consist of false positive diagnoses in which normal sadness is misdiagnosed as MDD. Data on uncomplicated depression suggest that many individuals who currently meet the DSM criteria for MDD are at no greater risk for subsequent depressive episodes, attempting suicide, or development of generalized anxiety disorder than members of the general population. These data suggest that uncomplicated depression is normal sadness, not major depression, and should not be diagnosed as disordered. They thus indicate that current DSM criteria for MDD are overly inclusive.

scholarly journals Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Sanne M Hendriks ◽  
Carmilla MM Licht ◽  
Jan Spijker ◽  
Aartjan TF Beekman ◽  
Florian Hardeveld ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Cognitive Profiles ◽  
Major Depressive

scholarly journals An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study

2016 ◽  
Vol 19 (6) ◽  
pp. 619-627 ◽  
Author(s):  
Lisa Mather ◽  
Victoria Blom ◽  
Gunnar Bergström ◽  
Pia Svedberg
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Environmental Factors ◽  
Depressive Disorder ◽  
Generalized Anxiety Disorder ◽  
Common Factor ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Common Pathway

Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005–2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69–0.74) between MDD and GAD, 0.58 (0.56–0.60) between MDD and burnout, and 0.53 (0.50–0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.

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