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How many different symptom combinations fulfil the diagnostic criteria for major depressive disorder? Results from

Seon-Cheol Park1, Jae-Min Kim2, Tae-Youn Jun3

  • 1a Department of Psychiatry , Inje University Haeundae Paik Hospital , Busan , Republic of Korea.

Nordic Journal of Psychiatry
|December 17, 2016
PubMed

Insights

Major Depressive Disorder (MDD) diagnosis shows significant heterogeneity, with 119 distinct symptom combinations found in Korean patients. This highlights the disorder

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Major Depressive Disorder (MDD) diagnosis exhibits polythetic criteria in DSM-IV and DSM-5, leading to inherent diagnostic heterogeneity.
  • This heterogeneity complicates consistent diagnosis and treatment of MDD.

Purpose of the Study:

  • To quantify the number and frequency of distinct depressive symptom combinations meeting DSM-IV criteria in Korean MDD patients.
  • To investigate the extent of diagnostic heterogeneity within the MDD population.

Main Methods:

  • Utilized data from the Clinical Research Center for Depression (CRESCEND) study in South Korea.
  • Included 853 MDD patients diagnosed via DSM-IV and scoring >= 8 on the Hamilton Depression Rating Scale (HAMD).
  • Performed descriptive statistical analyses to assess diagnostic variations.

Main Results:

  • Identified 119 unique combinations of depressive symptoms among the study participants.
  • The most frequent combination included all nine assessed depressive symptom profiles.
  • Nine specific symptom combinations were found in over 3% of the patient cohort.

Conclusions:

  • Findings confirm significant diagnostic heterogeneity in MDD, challenging the notion of a single underlying pathological process.
  • The results support the concept of MDD diagnoses being based on 'family resemblances' among varied symptom clusters rather than a singular cause.
Abstract

Keywords:
Major depressive disorderdepressive symptom combinationsdiagnostic heterogeneityfamily resemblancespolythetic definition

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