The DSM-IV (depression) classification: to be or note to be?

Article Abstract:

The Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), is primarily dependent upon, and significantly limited by nosology, the science of description or classification of diseases. It falls short of providing an adequate classification of a full range of depressive disorders, and the DSM-III is flawed in its definition and diagnosis of these disorders. Diagnosis is based on the presence of a certain number of symptoms, and does not consider symptoms in terms of priority. The duration and intensity of the symptoms, as well as the personality structure of the patient, are not always adequately considered. Depressive disorder may vary within one syndrome and the symptoms may not relate specifically to a particular one listed in the DSM-III. Three examples of diagnostic flaws are provided which illustrate this point. Causes of the psychiatric disorder are not a part of the DSM-III diagnostic classification, which should be considered; the potential importance of these factors can make them an indispensable part of diagnosis. Another flaw of the DSM-III is that multiple syndromes in a patient may be overlooked. For example, major depression has to be disregarded in the presence of schizophrenia. After 30 years of modern psychiatry, the classification of many disorders is just as confusing as ever. The concept of creating a classification is not wrong, but the DSM-III has not provided the clarification of psychiatric disorders that it should. The system is backward in the way that it works. Taxonomy dominates in determining what is to be considered in a diagnostic definition, rather than research. To remedy this, a moratorium should be placed on any further alterations in classifying depression and other psychiatric disorders, and any further changes should be based solely on the results of research. (Consumer Summary produced by Reliance Medical Information, Inc.)

Identification and classification, editorial, Diagnostic and Statistical Manual of Mental Disorders (Book)

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Replicated factor structure of the Beck Depression Inventory

Article Abstract:

The importance assigned to various factors by a standardized test for depression was examined. The test, the Beck Depression Inventory, is a self-rating 21-item questionnaire. The study was carried out on 370 patients aged between 22 and 88 years, 98 percent of whom were men. Results indicated that the test comprehensively measures all aspects of depression, as intended. However, half its questions contribute little information useful for predicting mental illness. Beck scores are not strongly related to the vegetative symptoms of depression traditionally used by psychiatry, but this is only due to the method originally used to construct the test and reveals nothing about the fundamental nature of depression.

Beck Depression Inventory

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Update on instruments to measure DSM-III and DSM-III-R personality disorders

Article Abstract:

Questionnaires and other standardized diagnostic techniques for personality disorders have recently been revised. Innovative new diagnostic instruments include self-reporting questionnaires, some of which are used in conjunction with an interview. Other new techniques include an interview to be given by trained lay people and a family history measure for diagnosing various personality disorders. The differences between these and older instruments are described. Psychiatric instruments require more validity testing and more consistent results between repeat testing sessions. Discrepancies between different instruments must be addressed.

Equipment and supplies

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