title: Introducing the concept of modern depression in Japan; an international case vignette survey.
abstract: OBJECTIVE
  Japanese psychiatrists have increasingly reported patients with depression that does not seem to fit the criteria of the ICD-10 and the DSM-IV, and which has recently been called modern type depression (MTD). We explored whether MTD is frequently seen in Japan and also in other countries, and if so, how patients with MTD are diagnosed and treated.
  
  
  METHODS
  The questionnaires, with two case vignettes (traditional type depression (TTD) and MTD), were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated their opinions about each case's prevalence in their country, etiology, diagnosis, suicide risk, and treatment using Likert scales.
  
  
  RESULTS
  Out of 247 responses (123 from Japan and 124 from other countries), two hundred thirty-nine valid responses were received. MTD was recognized in all participating countries, and especially in urban areas. Generally, the factor of personality was regarded as the most probable cause of MTD. Whereas about 90% of Japanese psychiatrists applied the ICD/DSM criteria to TTD, only about 60% applied the criteria to MTD.
  
  
  CONCLUSIONS
  Our results indicate that Japan's MTD seems to be occurring in many other countries, and that the present ICD/DSM criteria may not be sufficient to diagnose MTD. Therefore, it could be an important candidate for a new international diagnostic criterion as a subtype of depression. A clear diagnostic framework and consensus on the interventions to treat MTD would be valuable. Further clinical, psychopathological and international epidemiological studies are needed to confirm our preliminary findings of MTD.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. takahiro@npsych.med.kyushu-u.ac.jp
authors.forename: Takahiro A
authors.initials: TA
authors.lastname: Kato
authors.forename: Naotaka
authors.initials: N
authors.lastname: Shinfuku
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujisawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Tateno
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishida
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Akiyama
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
authors.forename: Alan R
authors.initials: AR
authors.lastname: Teo
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Choi
authors.forename: Anne P F
authors.initials: AP
authors.lastname: Wand
authors.forename: Yatan Pal Singh
authors.initials: YP
authors.lastname: Balhara
authors.forename: Jane Pei-Chen
authors.initials: JP
authors.lastname: Chang
authors.forename: Rita Yuan-Feng
authors.initials: RY
authors.lastname: Chang
authors.forename: Behrang
authors.initials: B
authors.lastname: Shadloo
authors.forename: Helal Uddin
authors.initials: HU
authors.lastname: Ahmed
authors.forename: Tiraya
authors.initials: T
authors.lastname: Lerthattasilp
authors.forename: Wakako
authors.initials: W
authors.lastname: Umene-Nakano
authors.forename: Hideki
authors.initials: H
authors.lastname: Horikawa
authors.forename: Ryohei
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Kuga
authors.forename: Masuo
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Kanba
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001459:Bangladesh; D003625:Data Collection; D003863:Depression / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007194:India; D038801:International Classification of Diseases; D007492:Iran; D007564:Japan / Q000453:epidemiology; D007723:Korea; D008297:Male; D008875:Middle Aged; D010551:Personality; D010554:Personality Disorders / Q000175:diagnosis; D011570:Psychiatry; D013405:Suicide; D011795:Surveys and Questionnaires; D013624:Taiwan; D013785:Thailand; D014481:United States; D055815:Young Adult