Abstract
Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with heterogenous psychological disturbances revealed that all six competing operational definitions of Major Depression (including DSM-III-R and ICD-10) were too restrictive to serve as a general concept of depression. Another polydiagnostic study in 500 primary care outpatients showed that more than two-thirds of all non-chronic depressed cases were below the severity threshold of Major Depression: these patients are classified as Depression Not Otherwise Specified (NOS) by DSM-III-R. Loosening of the over-restrictive time criteria would broaden the concept of Major Depression so as to meet the requirements of a general concept of depression, while the definition of Minor Depression below the threshold of Major Depression would add to a reduction of cases of NOS Depression by more than 80%. For the evaluation of antidepressant drugs in out-patient samples, we propose that patients with these modified definitions of Major and Minor Depression be included, provided they meet a minimum severity criterion of 13 or more points on the Hamilton Depression Scale; four-fifths of the modified Major Depression group and one-third of the Minor Depression group do in fact meet this criterion.
Similar content being viewed by others
References
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn, (DSM-III). APA, Washington
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn Revised, (DSM-III-R). APA, Washington
Delmo CD, Philipp M (1989) Computer programme for calculating criteria, syndromes and diagnoses for the Polydiagnostic Interview PODI, Version 2.1. Department of Psychiatry, University of Mainz
Feighner JP (1981) Nosology of primary affective disorders and application to clinical research. Acta Psychiatr Scand [suppl 190] 63:29–41
Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G, Munoz R (1972) Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 26:57–63
Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62
Paykel ES, Hollyman JA, Freeling P (1988) Predictors of therapeutic benefit from amitriptyline in mild depression: a general practice placebo-controlled trial. J Affective Disord 14:83–95
Philipp M, Delmo CD (1987) Polydiagnostic Interview PODI, Version 2.1. Department of Psychiatry, University of Mainz
Philipp M, Delmo CD (1988) Outpatient-version 3.0 of the Polydiagnostic Interview. Department of Psychiatry, University of Mainz
Philipp M, Maier W (1986) The polydiagnostic interview: a structured interview for polydiagnostic classification of psychiatric patients. Psychopathology 19:175–185
Philipp M, Maier W (1987) Diagnosensysteme endogener Depressionen. Springer, Berlin Heidelberg New York
Philipp M, Maier W (1991) Descriptive and clinical validity of concepts of endogenous depression: comparison of ICD-10, DSM-III-R and 16 other operational definitions. In: Stefanis C (ed) Psychiatry 1989. Proceedings of the VIIIth World Congress of Psychiatry. Elsevier, Amsterdam (in press)
Philipp M, Maier W, Benkert O (1985) Operational diagnosis of endogenous depression. II. Comparison of 8 different operational diagnoses. Psychopathology 18:218–225
Philipp M, Maier W, Delmo CD (1991a) The concept of Major Depression. I. Descriptive comparison of six competing operational definitions including ICD-10 and DSM-III-R. Eur Arch Psychiatr Neurol Sci 240:258–265
Philipp M, Maier W, Delmo CD (1991b) The concept of Major Depression. II. Empirical comparison of six competing operational definitions in 600 psychiatric inpatients. Eur Arch Psychiatr Neurol Sci 240:266–271.
Philipp M, Maier W, Delmo CD (1991c) The concept of Major Depression. III. Concurrent validity of six competing operational definitions for the ICD-9 diagnosis. Eur Arch Psychiatr Neurol Sci 240:272–278
Spitzer R, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 35:773–782
Winter P, Philipp M, Buller R, Delmo CD, Schwarze H, Benkert O (1991) Identification of minor affective disorders and implications for psychopharmacotherapy. J Affective Disord (in press)
World Health Organisation (1987) April 1987 draft of the ICD-10 diagnostic criteria for research, chapter V: mental and behavioural disorders (F00–F99). WHO, Geneva
World Health Organisation (1989) April 1989 draft of the ICD-10 diagnostic criteria for research, chapter V: mental and behavioural disorders (F00–F99). WHO, Geneva
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Philipp, M., Delmo, C.D., Buller, R. et al. Differentiation between major and minor depression. Psychopharmacology 106 (Suppl 1), S75–S78 (1992). https://doi.org/10.1007/BF02246241
Issue Date:
DOI: https://doi.org/10.1007/BF02246241