European Perspectives on the Classification of Depression

The publication by the American Psychiatric Association in 1980 of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) - a text whose influence has been felt throughout the entire world and whose system of classification, particularly within the context of depressive disorders, has now been adopted by the majority of research work, no matter in what country it is implemented or published - has given the impression that an ‘American perspective’ has been substituted for the ‘European perspective’ that was predominant up to that point. However, this is a simplistic view of a complex history. Certainly, the basic methods of DSM-III originated from within those traditions which are particularly rooted in the USA, such as the quantitative approach to diagnostic criteria; these derive in the final analysis from the ‘statistical psychology’ devised by James McKeen Cattell at the University of Pennsylvania in 1887, and subsequently taught by him at Columbia University. But even among those factors which appear to be characteristically American, European origins can be detected: when he was in London, Cattell was the pupil of Galton, the founder of biometry. Furthermore, there has never existed in Europe any unanimity of opinion with regard to the problems of nosology: concepts supported in the German-speaking countries, in France, in the UK, or in the Scandinavian countries have only been partially adopted elsewhere and occasionally have remained specific to their national tradition. This paper will examine two of the fundamental points in the classification of depression which are linked to European perspectives - the notion of affective disorder and the endogenous/non-endogenous dichotomy - and will discuss the present situation created by the discordance which exists between the European and American approaches.