Reconceptualizing Depression, and the Current Scene on Dimensionality and the RDoC

Abstract

To determine the qualities of an ideal trial and its requirements, the foundation, i.e., the concept of the depressive disorder, must be reexamined. What has been learned about the concept during these past five decades? The “dimensional” concept based on years of research, developed in the author’s 2013 book “Depression and Drugs”, should replace the traditionally accepted core syndrome concept. This transformation can result in creating a trial model that generates a profile of drug-induced actions on the components or dimensions of the disorder. It thereby, extends the information obtained from such trials well beyond the currently limited information on treatment outcome obtained from the established model. The latter model rests solely on changes in the overall severity of the disorder. The chapter assesses developments on the current scene of the new DSM-5 and the RDoC, regarding the application of dimensions, and details the new behavioral targets for drugs aimed at resolving the disorder.