Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria

Lux, Vanessa; Kendler, Kenneth S.

doi:10.1017/s0033291709992157

Cited by 182 publications

(167 citation statements)

References 42 publications

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“…First, intraindividual analyses of multivariate time series of variables related to MDD symptomatology show clear interactions between these variables (15)(16)(17). Second, MDD symptoms display distinct responses to different life events (18,19) and are differently related to other external variables and disorders (20), which is consistent with a network view of interacting variables related to MDD…”

supporting

confidence: 72%

Critical slowing down as early warning for the onset and termination of depression

Leemput

Wichers

Cramer

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

628

577

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About 17% of humanity goes through an episode of major depression at some point in their lifetime. Despite the enormous societal costs of this incapacitating disorder, it is largely unknown how the likelihood of falling into a depressive episode can be assessed. Here, we show for a large group of healthy individuals and patients that the probability of an upcoming shift between a depressed and a normal state is related to elevated temporal autocorrelation, variance, and correlation between emotions in fluctuations of autorecorded emotions. These are indicators of the general phenomenon of critical slowing down, which is expected to occur when a system approaches a tipping point. Our results support the hypothesis that mood may have alternative stable states separated by tipping points, and suggest an approach for assessing the likelihood of transitions into and out of depression. D epression is one of the main mental health hazards of our time. It can be viewed as a continuum with an absence of depressive symptoms at the low endpoint and severe and debilitating complaints at the high end (1). (Throughout this manuscript, the term "depression" refers to this continuum of depressive symptoms.) The diagnosis major depressive disorder (MDD) defines individuals at the high end of this continuum. Approximately 10-20% (2) of the general population will experience at least one episode of MDD during their lives, but even subclinical levels of depression may considerably reduce quality of life and work productivity (3). Depressive symptoms are therefore associated with substantial personal and societal costs (4,5). The onset of MDD in an individual can be quite abrupt, and similarly rapid shifts from depression into a remitted state, so-called sudden gains, are common (6). However, despite the high prevalence and associated societal costs of depression, we have little insight into how such critical transitions from health to depression (and vice versa) in individuals might be foreseen. Traditionally, the broad array of correlated symptoms found in depressed people (e.g., depressed mood, insomnia, fatigue, concentration problems, loss of interest, suicidal ideation, etc.) was thought to stem from some common cause, much as a lung tumor is the common cause of symptoms such as shortness of breath, chest pain, and coughing up blood. Recently, however, this common-cause view has been challenged (7-9). The alternative view is that the correlated symptoms should be regarded as the result of interactions of components of a complex dynamical system (7,(10)(11)(12). Consequently, new models of the etiology of depression involve a network of interactions between components, such as emotions, cognitions, and behaviors (8,9). This implies, for instance, that a person may become depressed through a causal chain of feelings and experiences, such as the following: stress → negative emotions → sleep problems → anhedonia (9, 13-15). However, the network view also implies that there can be positive feedback mechanisms between symptoms, such...

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supporting

confidence: 72%

Critical slowing down as early warning for the onset and termination of depression

Leemput

Wichers

Cramer

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

628

577

View full text Add to dashboard Cite

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“…This did not happen to HAM-D 6 , because the missing value was on item 5 of the HDRS-17 (intermediate insomnia), which is not part of the HAM-D 6 . So, the subject was re-included in the analysis of HAM-D 6 .…”

Section: Resultsmentioning

confidence: 99%

“…The World Health Organization presented a report in 2011 estimating that depressive disorders were the second leading cause of years lived with disability [2]. However, several studies show that MDD is a very heterogeneous syndrome [3][4][5][6] that is characterized by many different presentations and possibly with different risk factors for its individual symptoms [7,8]. Actually, MDD DSM-V [9] are quite similar to DSM-III criteria released in 1980 [10]; there are only minor changes regarding bereavement [11].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, when HAM-D 6 was constructed, Bech et al (1981) used Rasch analysis [31], but the method has been improved since then, making it possible to work with items with different numbers of categories [33]. In his original study of HAM-D 6 , Bech showed that work and activities and depressed mood represent the less severe symptoms, while feelings of guilt and psychomotor retardation represent the most severe melancholic features. However, the main focus of Bech studies was to establish a comparison between scales and showing the property of HAM-D 6 unidimensionality rather than aiming to set up a symptom hierarchy in the evaluation of melancholic depression [32].…”

Section: Introductionmentioning

confidence: 99%

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The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 Items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome

et al. 2017

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ObjectivesMelancholic features of depression (MFD) seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder. MethodsWe evaluated both the Hamilton depression rating scale (HDRS-17) and its 6-item melancholic subscale (HAM-D6) in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean (±SD) of items and persons residual = 0 (±1); low χ 2 value; p>0.01. ResultsFor ConclusionsDepressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression as a continuum of PLOS ONE |

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“…Most of the studies evaluated depression as a unidimensional/single concept diagnosis or a total score on a questionnaire, whereas depression most likely is a heterogeneous condition. [2][3][4] Symptoms of depression are drooping mood, feeling of guilt, suicide ideation, insomnia, agitation, anxiety, weight loss etc. Types of depression include unipolar, bipolar and dysthymic disorder.…”

Section: Introductionmentioning

confidence: 99%

Levels of Serum Folate and Cobalamine in Clinically Depressed Patients in North Indian Population

Baradia¹,

Kumar²,

Seth³

et al. 2018

AIMDR

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Background: Depression, the most common type of mental illness is the second leading cause of disability worldwide next to CAD. Vitamin B6, folate and vitamin B12 are involved in a series of methylation reaction that produce monoamine neurotransmitters, phospholipids and nucleotide. Therefore the present study was planned to assay the blood levels of vitamin B12 and folate in patients with depression. The objective of this was to study if metabolites are affected by diet and may be helpful in the prevention of depression. Methods: Current study was an experimental case control study, was conducted at Santosh Medical College. A total of 88 cases (44 patients and 44 controls) both males and females in the age between 18 -65 years were included in the study. Hamilton depression rating scale (HDRS) -17 items scale was used to rate the level of depression. Results: In the present study a total of 88 subjects including 45 females and 43 males participated, out of which 44 were control, 24 males and rest 20 were females. Majority 55 patients were of no depression category, 11 were of mild depression category, 10 were of severe depression and rest 9, were of moderate depression category. Mean value of B12 were found lowest in 'moderate' depressed patients (115), than in 'most severe depressed' (137), followed by 'severe' and 'mild' depressed patients category. Value of HDRS increases with severity of depression, it was found lowest in the 'mild' (10.64), then it steadily increases with severity, moderate (15.11), severe (21.20) and most severe (27.55). Conclusion: This study showed that majority of the patients with clinical depression had vitamin B12 deficiency.

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Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria

Abstract: Background-The DSM-IV symptomatic criteria for major depression (MD) derive primarily from clinical experience with modest empirical support.

Cited by 182 publications

References 42 publications

Critical slowing down as early warning for the onset and termination of depression

Critical slowing down as early warning for the onset and termination of depression

The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 Items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome

Levels of Serum Folate and Cobalamine in Clinically Depressed Patients in North Indian Population

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