Through a glass darkly: the disutility of the DSM nosology of depressive disorders.
OBJECTIVE
To demonstrate that the dimension-weighted DSM-IV model for classifying the depressive disorders lacks utility.


METHODS
The logical flaws in classifying the depressive disorders with any severity-based model (which underpin both the DSM-IV and ICD-10 systems) are noted. Integral definitional limitations to the DSM-IV definition of key depressive disorders are identified. It is argued that the DSM-IV classificatory system lacks utility for providing information on etiology and preferential management strategies. An alternative subtyping model is considered.


RESULTS
It is asserted that, in practice, the DSM-IV model and criteria lack explanatory power and compromise research and clinical practice.


CONCLUSIONS
It is hoped that this article evokes wider debate about modelling and classifying the depressive disorders.
Parker
Gordon
G
School of Psychiatry, University of New South Wales, Sydney, Australia. g.parker@unsw.edu.au
D003866:Depressive Disorder / Q000145:classification* / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D015203:Reproducibility of Results