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  • 1
    ISSN: 1433-8491
    Keywords: Major depression ; Unipolar depression ; Endogenous depression ; Polydiagnostic classification ; Alcoholism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The endogenous/non-endogenous distinction of unipolar major depression is widely accepted, as is the family study approach to the validation of diagnostic distinctions. Rates of affective disorders were examined in 689 first-degree relatives of 184 patients with unipolar major depresion and were compared with 312 first-degree relatives of 80 healthy controls. Only unipolar depression and alcoholism were more common in families of depressed probands compared with families of healthy controls. As a variety of diagnostic definitions of endogenous depression have been proposed, probands and relatives were diagnosed in a polydiagnostic manner. None of the five diagnostic definitions of endogenous depression was able to identify patients with an increased familial risk of unipolar depression.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-8491
    Keywords: Major depression ; Operational diagnosis ; ICD-10 ; DSM-III-R
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary All operationalized diagnostic systems contain a diagnostic category, which corresponds to the concept of major depression. Yet, these corresponding definitions are not identical. Up to now, no comprehensive comparisons of the competing diagnoses have been published. We will therefore present a series of studies, describing six different operational definitions of major depression according to their content and construction and empirically comparing them in large inpatient and outpatient samples. This first paper presents a descriptive comparison of the definitions given in the Feighner Diagnostic Criteria, the Research Diagnostic Criteria, the Diagnostic and Statistical Manual of Mental Disorders, third edition and third edition, revised, and in two developmental drafts of the ICD-10 diagnostic criteria for research (draft April 1987–187; draft April 1989–189). The descriptive comparison will demonstrate that there are many similarities, especially concerning the symptom-criteria of major depression. Classificatory relevance could only be assumed for those differences found for cut-offs, for time criteria and especially for exclusion criteria. Whether these differences are negligible and whether patients classified by different diagnostic systems are really comparable will be examined in subsequent publications.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-8491
    Keywords: Major depression ; Operational diagnosis-ICD-10 ; DSM-III-R
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Six operational definitions of the concept of major depression were submitted to empirical evaluation in 600 psychiatric inpatients. Special attention was given to the comparison of major depression in DSM-III-R and ICD-10. The data base created by a polydiagnostic interview revealed relevant classificatory differences between the six definitions under study. Sources of different diagnostic base rates were: inclusion or omission of anhedonia as an obligatory mood criterion; minimal number of syndrome criteria required for the syndrome diagnosis; different width and reference points of time criteria; exclusion rules for co-existing schizophrenic symptoms and for previous nonaffective and manic episodes. The empirically evaluated overlap between pairs of diagnostic definitions was less than excellent in most of the diagnostic definitions under study; only the DSM-III and DSM-III-R definitions agreed with each other to a highly comparable degree. The relatively good agreement of the 1989 draft definition of ICD-10 for major depression (“mild depression”) with the other five operational definitions (kappa=0.69) led us to expect that this definition should receive sufficient international acceptance.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-8491
    Keywords: Major depression ; Operational diagnosis ; Concurrent validity ; ICD-10 ; DSM-III-R
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The comparative validity of six operational diagnoses of major depression was evaluated in 600 psychiatric inpatients using the independently assessed clinical ICD-9 diagnoses as a yardstick. Agreement with, and positive predictive value for the ICD-9 categories of pure (endogeneous and psychogenic) depression served as validation criteria; sensitivity of major depression diagnoses for detecting ICD-9 bipolar depressions was additionally used for examining the adequacy of width, time and exclusion criteria of the competing operational definitions. Three essential results were found. First, the “old” diagnostic definitions of RDC and FDC are superior to all newer definitions because they define the time criteria and the schizophrenic exclusion criteria more adequately than, for example, both DSM-III and DSM-III-R definition. Secondly, the current ICD-10 definition of 1989 (“mild”, “moderate” or “severe” depression) comes closer to the concurrent validity of RDC and FDC than DSM-III, DSM-III-R and the previous ICD-10 definition of 1987. Thirdly, using the criterion of identifying a high proportion of ICD-9 bipolar depressions, all six competing diagnostic systems are too restrictive. Evaluations of predicitive and criterion-related validity will be needed to substantiate these findings.
    Type of Medium: Electronic Resource
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