Elsevier

Comprehensive Psychiatry

Volume 23, Issue 4, July–August 1982, Pages 330-338
Comprehensive Psychiatry

A transatlantic view of the diagnosis of depressions according to the DSM III: II did the DSM III solve the problem of depression diagnosis?

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Abstract

Current depression diagnosis is chaotic, and the DSM III creates order in this chaos in many ways. First of all because it sharply defines the various categories. Secondly because it settles several controversial points. a. The vital (“endogenous”) depressive syndrome is an aetiologically non-specific rather than an endogenously determined syndrome. b. Vital depressivity and neurotic personality structure are not mutually exclusive. c. Relapse tendency (“unipolarity”) is not an exclusive characteristic of the vital depression.

On another, very important point, however, the DSM III is inadequate. Today there are strong indications that depressions differ not only quantiatively but also in qualitative (syndromal) terms, and that the dimensions symptomatology and severity are inter-independent. The DSM III is ambiguous on this point, and this is unfortunte both for therapy and for research.

The DSM III is not a codex. It invites critical analysis, but this does not in any way reduce one's admiration for this monumental oeuvre.

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1

H.M. van Praag, M.D., Ph.D., Professor of Psychiatry at the University of Utrecht, Department of Psychiatry, University Hospital, Utrecht, The Netherlands. Professor and Chairman of Psychiatry, Albert Einstein College of Medicine and Montefiore Hospital and Medical Center, Bronx, New York.

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