To effectively treat patients with depression, physicians need a clear understanding of the current systems of classification for depressive disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM IV) divides affective disorders into 10 categories: major depression; bipolar I, bipolar II, dysthymic, and cyclothymic disorders; mood disorders due to medical conditions and due to substance abuse; and depressive, bipolar, and mood disorders not otherwise specified.1 We first explore diagnostic and therapeutic concepts, highlighting the structure behind the current understanding of these disorders. Then we discuss the application of these concepts to the process of evaluation and treatment of patients, including special populations.
KeywordsBipolar Disorder Major Depression Affective Disorder Mood Disorder Selective Serotonin Reuptake Inhibitor
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- 1.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th rev ed. Washington, DC: APA, 1994.Google Scholar
- 3.Williamson PS, Yates WR. The initial presentation of depression in the family practice and psychiatric outpatients. Arch Gen Psychiatry 1989;11:188–93.Google Scholar
- 6.Lewinsohn PM. A behavioral approach to depression. In: Friedman R, editor. The psychology of depression: contemporary theory and research. New York: Wiley, 1974:157–85.Google Scholar
- 7.Beck AT. Depression: causes and treatment. Philadelphia: University of Pennsylvania Press, 1972.Google Scholar
- 8.Andreasen NC, Black DW Introductory textbook of psychiatry. Washington, DC: American Psychiatric Press, 1990:191.Google Scholar
- 9.Gutheil TG, Bursztajn H, Brodsky A. The multidimensional assessment of dangerousness: confidence assessment in patient care and liability prevention. Bull Am Acad Psychiatr Law 1986;14:123–9.Google Scholar
- 11.Electroconvulsive therapy: consensus conference. JAMA 1985; 254(15):2103–8.Google Scholar
- 12.Janicak PG, Boshes RA. Advances in the treatment of mania and other acute psychotic disorders. Psychiatr Ann 1987;17: 145–9.Google Scholar
- 13.Scott WC. Treatment of depression by primary care physicians: psychotherapeutic treatments for depression. In: Informational report of the Council on Scientific Affairs, American Medical Association. Chicago: AMA, 1991.Google Scholar
- 14.Puig-Antich J, Ryan ND, Rabinovitch H. Affective disorders in childhood and adolescence. In: Weiner JM, editor. Diagnosis and psychopharmacology of childhood and adolescent disorders. New York: Wiley, 1985.Google Scholar