Clinical validity of a population database definition of remission in patients with major depression

BackgroundSeverity is an important characteristic of major depression (MD) and an ‘episode specifier’ in DSM-IV classifying depressive episodes as ‘mild’, ‘moderate’ or ‘severe’. These severity subtypes rely on three different measures of severity: number of criteria symptoms, severity of the symptoms and degree of functional disability. No prior empirical study has evaluated the coherence and validity of the DSM-IV definition of severity of MD.MethodIn a sample of 1015 (518 males, 497 females) Caucasian twins from a population-based registry who met criteria for MD in the year prior to interview, factor analysis and logistic regression were conducted to examine the inter-relationships of the three severity measures and their associations with a wide range of potential validators including demographic factors, risk for future episodes, risk of MD in the co-twin, characteristics of the depressive episode, the pattern of co-morbidity, and personality traits.ResultsCorrelations between the three severity measures were significant but moderate. Factor analysis indicated the existence of a general severity factor, but the factor was not highly coherent. The three severity measures showed differential predictive ability for most of the validators.ConclusionsSeverity of MD as defined by the DSM-IV is a multifaceted and heterogeneous construct. The three proposed severity measures reflect partly overlapping but partly independent domains with differential validity as assessed by a wide range of clinical characteristics. Clinicians should probably use a combination of severity measures as proposed in DSM-IV rather than privileging one.

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Sub-Grouping Non-Melancholic Major Depression Using Both Clinical and Aetiological Features

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.1999.00545.x ◽

1999 ◽

Vol 33 (2) ◽

pp. 217-225 ◽

Cited By ~ 7

Author(s):

Gordon Parker ◽

Kay Roy ◽

Kay Wilhelm ◽

Phillip Mitchell ◽

Marie-Paule Austin ◽

...

Keyword(s):

Major Depression ◽

Clinical Importance ◽

Dimensional Approach ◽

Treatment Utility ◽

Major Depressive ◽

Predisposing Factor ◽

Personality Functioning ◽

Combined Solution ◽

Cluster Analytic ◽

Definition Of

Objective: In previous papers we have considered the extent to which two contrasting analytic approaches, examining reported clinical symptom variables alone and aetiological variables alone, assist definition of subgroups of non-melancholic major depression. Here, we address the same objective but combine both sets of variables, and contrast the combined solution with each of the contributing ones. Method: We study a sample of 185 subjects with a putative non-melancholic major depressive disorder, with analyses involving 13 aetiological and 38 symptom variables. Results: A four-class subgrouping was derived by use of a cluster analytic technique, with ‘neurotic depression’, non-anxious ‘depressed’, ‘situational’ and ‘residual’ groups. The largest group comprised ‘neurotic depression’ subjects, with characteristics compatible with a spectrum disorder encompassing both clinical features as well as an underlying temperament and personality style marked by anxiety. Conclusions: Comparative advantages and properties of the three differing analytic approaches to defining ‘meaningful’ non-melancholic major depressive subgroupings are considered. As a ‘neurotic depressive’ class has been consistently identified across those three approaches, but with quite varying numbers of subjects circumscribed, it is clearly a ‘fuzzy’ entity which may benefit from a dimensional approach to its measurement. As many of the non-melancholic groupings appear secondary to a substantive predisposing factor such as anxiety or disordered personality functioning, the clinical importance and treatment utility in identifying and circumscribing such classes are clearly supported.

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Clinical validity of major depression-endogenous subtype in adolescent patients

European Child & Adolescent Psychiatry ◽

10.1007/bf00571675 ◽

1996 ◽

Vol 5 (3) ◽

pp. 155-161 ◽

Cited By ~ 6

Author(s):

A. Wood ◽

A. Moore ◽

R. Harrington ◽

D. Jayson

Keyword(s):

Major Depression ◽

Clinical Validity ◽

Adolescent Patients

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Definition of Apathy and Differential Diagnosis

10.1093/med/9780198841807.003.0001 ◽

2021 ◽

pp. 1-18

Author(s):

Philippe Robert ◽

Valeria Manera

Keyword(s):

Differential Diagnosis ◽

Clinical Practice ◽

Major Depression ◽

Diagnostic Criteria ◽

Brain Disorders ◽

Theoretical Level ◽

Neuropsychiatric Diseases ◽

Definition Of

Motivation, initiation, interest, goal-directed behaviour, reward, and incentive are just some of the words associated with the concept of apathy in brain disorders. This vocabulary is even richer if we encompass different neuropsychiatric diseases, such as schizophrenia and major depression. This is a paradox for this concept, which is so difficult to capture and to define at the theoretical level, and at the same time easy to understand and observe in clinical practice. This chapter aims to summarize the different apathy definitions, present the diagnostic criteria for apathy in brain disorders, and discuss differential diagnosis and overlap with other conditions, such as anhedonia, fatigue, and depression.

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Reconsidering the definition of Major Depression based on Collaborative Psychiatric Epidemiology Surveys

Journal of Affective Disorders ◽

10.1016/j.jad.2016.09.014 ◽

2017 ◽

Vol 207 ◽

pp. 38-46 ◽

Cited By ~ 9

Author(s):

Tom Rosenström ◽

Markus Jokela

Keyword(s):

Major Depression ◽

Psychiatric Epidemiology ◽

Definition Of

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The uniqueness of the DSM definition of post-traumatic stress disorder: implications for research

Psychological Medicine ◽

10.1017/s0033291701004998 ◽

2002 ◽

Vol 32 (4) ◽

pp. 573-576 ◽

Cited By ~ 39

Author(s):

N. BRESLAU ◽

G. A. CHASE ◽

J. C. ANTHONY

Keyword(s):

Major Depression ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Sleep Problems ◽

Traumatic Event ◽

Post Traumatic Stress ◽

Specific Syndrome ◽

Post Traumatic ◽

Definition Of

The official definition of post-traumatic stress disorder (PTSD) in DSM-III and is subsequent DSM editions is based on a conceptual model that brackets traumatic or catastrophic events from less severe stressors and links them with a specific syndrome. The diagnosis of PTSD requires an identifiable stressor and the content of the defining symptoms refers to the stressor, for example, re-experiencing the stressor and avoidance of stimuli that symbolize the stressor. Temporal ordering is also required: when sleep problems and other symptoms of hyperarousal are part of the clinical picture, they must not have been present before the stressor occurred. The ICD-10 definition of PTSD follows the same model. The defining symptoms alone, without a connection to the stressor, are not regarded as PTSD (Green et al. 1995). Since the introduction of PTSD in DSM-III, the official definition has been adopted in most studies, although discussions about the validity of the definition has continued (Breslau & Davis, 1987; Davidson & Foa, 1993; Green et al. 1995). Although it is widely believed that other disorders (e.g. major depression) can be precipitated by external events, these disorders can occur independent of stressors and do not require a link with a traumatic event in their diagnostic criteria. Previous classifications that separated major depression into stress-related (reactive) or endogenous have been abandoned in newer versions of the DSM, because of lack of evidence of the validity of this distinction.

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Depression and Pancreatic Cancer

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2007.0012 ◽

2007 ◽

Vol 5 (1) ◽

pp. 113-116 ◽

Cited By ~ 17

Author(s):

Andrew D. Boyd ◽

Michelle Riba

Keyword(s):

Pancreatic Cancer ◽

Major Depression ◽

Pancreatic Carcinoma ◽

Mild Depression ◽

Definition Of ◽

Relationship Of

Although pancreatic carcinoma and depression have been linked for years, the prevalence and relationship of these often coexisting diseases are still poorly understood. A clinical gestalt asserts that many patients present with depression before pancreatic carcinoma is diagnosed. Published studies reviewing this issue have found that many patients with pancreatic cancer are depressed. If the definition of depression is broadened to include mild depression in addition to major depression, these numbers increase. This article reviews the literature linking pancreatic carcinoma and depression.

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