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An alternative approach to future diagnostic standards for major depressive disorder

Authors
Kim, Yong-KuPark, Seon-Cheol
Issue Date
8-3월-2021
Publisher
PERGAMON-ELSEVIER SCIENCE LTD
Keywords
Major depressive disorder; Operational criteria; Heterogeneity; Network analysis; Research domain criteria (RDoC)
Citation
PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY, v.105
Indexed
SCIE
SCOPUS
Journal Title
PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY
Volume
105
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/49479
DOI
10.1016/j.pnpbp.2020.110133
ISSN
0278-5846
Abstract
During the period extending from 1780 to 1880, the conceptualization of melancholia changed from an intellectual to a mood model. The modern view of depression, based on Kraepelinian dualism, has reflected changes in opinion on psychiatric taxonomy of individual melancholia. From the point of view of an "operational revolution," the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) were based on a neoKraepelinian approach rooted in disease essentialism. In the revision process from the DSM-IV to the DSM-5, a combined dimensional and categorial approach was used. In the DSM-5, the diagnostic criteria for major depressive disorder are polythetic and operational in approach reflecting the heterogeneity of major depressive disorder. Although 227 different symptom combinations fulfilling the diagnostic criteria for major depressive disorder can be theoretically calculated, certain symptom combinations are more prevalent than others in real clinical situations. The heterogeneity of these operational criteria for major depressive disorder have been criticized in a manner informed by the Wittgensteinian analogy of the language game. Herein, our network analysis proposes a novel perspective on the psychopathology of major depressive disorder. The novel approach suggested here may lay the foundation for a redefinition of the traditional taxonomy of depression.
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