Depression in DSM-5: Changes, Controversies, and Future Directions

  • Seon-Cheol Park
  • Yong-Ku Kim


In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), categorical and dimensional approaches to diagnose depressive disorders have been combined, resulting in the following changes: (1) mood disorders have been dichotomized into bipolar and related disorders and depressive disorders; (2) “hopelessness” has been added to the subjective descriptors of depressive mood; (3) disruptive mood dysregulation disorder (DMDD) and premenstrual dysphoric disorder (PMD) have been introduced as new distinct disease entities; (4) dysthymic disorder has been re-labeled as persistent depressive disorder (PDD); (5) the bereavement exclusion in the definition of major depressive disorder (MDD) has been removed; and (6) the specifiers “with psychotic features,” “with anxious stress,” “with mixed features,” “with peripartum onset,” and others have been revised and/or introduced. However, despite the presence of transnosological specifiers, severity assessments, and cross-cutting symptom measure assessments, depressive disorders in DSM-5 are still diagnosed and classified based largely on categorical approaches. Moreover, the heterogeneity of MDD in terms of a polythetic operational diagnosis has been characterized as corresponding to a language game in Wittgensteinian philosophy. Etiologically based diagnostic systems for depressive disorders that consider sociocultural influences on depressive symptomatology and that take a humanistic approach that considers subjective and interpersonal contexts need to be developed.


Depression DSM-5 Humanistic approach Operational diagnosis Transnosological specifiers 


  1. Adam D. Mental health: on the spectrum. Nature. 2013;496(7446):416–8.CrossRefGoogle Scholar
  2. Altemus M, Neeb CC, Davis A, Occhiogrosso M, Nguyen T, Bleiberg KL. Phenotypic differences between pregnancy-onset and postpartum-onset major depressive disorder. J Clin Psychiatry. 2012;73(12):e1485–91.CrossRefGoogle Scholar
  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington: American Psychiatric Association; 1994.Google Scholar
  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  5. American Psychiatric Association Taskforce DV. Justification for temperament dysregulation disorder with dysphoria. Washington: American Psychiatric Association; 2010.Google Scholar
  6. Angst J, Azorin JM, Bowden CL, Perugi G, Vieta E, Gamma A, Young AH, BRIDGE Study Group. Prevalence and characteristics of undiagnosed bipolar disorders in patients with a major depressive episode: the BRIDGE study. Arch Gen Psychiatry. 2011;68(8):791–8.CrossRefGoogle Scholar
  7. Axelson D, Findling RL, Fistad MA, Kowatch RA, Youngstrom EA, Horwitz SM, Arnold E, Frazier TW, Ryan N, Demeter C, Gill MK, Hauser-Harrington JC, Depew J, Kennedy SM, Gron BA, Rowles BM, Birmaher B. Examining the proposed disruptive mood dysregulation disorder diagnosis in children in the longitudinal assessment of manic symptoms study. J Clin Psychiatry. 2012;73(10):1342–50.CrossRefGoogle Scholar
  8. Bandini J. The medicalization of bereavement: (Ab) normal grief in the DSM-5. Death Stud. 2015;39(6):347–52.CrossRefGoogle Scholar
  9. Beck AT, Steer RA, Beck JS, Newman CF. Hopelessness, depression, suicidal ideation, and clinical diagnosis of depression. Suicide Life Threat Behav. 1993;23(2):139–45.PubMedGoogle Scholar
  10. Berk M, Berk L, Moss K, Dodd S, Malhi GS. Diagnosing bipolar disorder: how can we do it better? Med J Aust. 2006;184(9):459–62.PubMedGoogle Scholar
  11. Biederman J, Faraone SV, Wozniak J, Mick E, Kwon A, Aleardi M. Further evidence of unique developmental phenotype correlates of pediatric bipolar disorder: findings from a large sample of clinically referred preadolescent children assessed over the last 7 years. J Affect Disord. 2004;82(Suppl 1):S45–58.CrossRefGoogle Scholar
  12. Blanco C, Okuda M, Markowitz JC, Liu SM, Grant BF, Hasin DS. The epidemiology of chronic major depressive disorder and dysthymic disorder: results from the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry. 2010;71(12):1645–56.CrossRefGoogle Scholar
  13. Brotman MA, Kassen L, Reising MM, Guyer AE, Dickstein DP, Rich BA, Towbin KE, Pine DS, McMahon FJ, Leibenluft E. Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation. Am J Psychiatry. 2007;164(8):1238–41.CrossRefGoogle Scholar
  14. Carlson GA, Potegal M, Margulies D, Gutkovitch Z, Baile J. Rages: what are they and who has them? J Child Adolesc Psychopharmacol. 2009;19(3):281–8.CrossRefGoogle Scholar
  15. Castiglioni M, Laudisa F. Toward psychiatry as a ‘human’ science of mind. The case of depressive disorder in DSM-5. Front Psychol. 2015;5:1517.CrossRefGoogle Scholar
  16. Cohen LS, Altshuler LL, Harlow BL, Nonacs R, Newport DJ, Viguera AC, Suri R, Burt VK, Hendrick V, Reminick AM, Loughead A, Vitonis AF, Stowe ZN. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA. 2006;295(5):499–507.CrossRefGoogle Scholar
  17. Copeland WE, Angold A, Costello EJ, Egger H. Prevalence, comorbidity and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry. 2013;170(2):173–9.CrossRefGoogle Scholar
  18. Coryell W, Young EA. Clinical predictors of suicide in primary major depressive disorder. J Clin Psychiatry. 2005;66(4):412–7.CrossRefGoogle Scholar
  19. Cross-Disorder Group of the Psychiatric Genomics Consortium. Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nat Genet. 2013;45(9):984–94.CrossRefGoogle Scholar
  20. Cuijper P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF 3rd. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013;12(2):137–48.CrossRefGoogle Scholar
  21. Di Florio A, Forty L, Gordon-Smith K, Heron J, Jones L, Craddock N, Jones I. Perinatal episodes across the mood disorder spectrum. JAMA Psychiat. 2013;70(2):168–75.CrossRefGoogle Scholar
  22. Dinya E, Csorba J, Grosz Z. Are there temperament differences between major depressive disorder and dysthymic disorder in adolescent clinical outpatients? Compr Psychiatry. 2012;53(4):350–4.CrossRefGoogle Scholar
  23. Eisenlohr TA, Girdler SS, Schmalenberger KM, Dawson DN, Surana P, Johnson JL, Rubinow DR. Toward the reliable diagnosis of DSM-5 premenstrual dysphoric disorder: the Carolina Premenstrual Assessment Scoring System (C-PASS). Am J Psychiatry. 2017;174:51–9.CrossRefGoogle Scholar
  24. Epperson CN, Steiner M, Hartlage SA, Eriksson E, Schmidt PJ, Jones I, Yonkers KA. Premenstrual dysphoric disorder: evidence for a new category for DSM-5. Am J Psychiatry. 2012;169(5):465–75.CrossRefGoogle Scholar
  25. Etain B, Lajnef M, Bellivier F, Mathiey F, Raust A, Cochet B, Gard S, M’Bailara K, Kahn JP, Elqrabli O, Cohen R, Jamain S, Vieta E, Leboyer M, Henry C. Clinical expression of bipolar disorder type I as a function of age and polarity at onset: convergent findings in samples from France and the United States. J Clin Psychiatry. 2012;73(4):e561–6.CrossRefGoogle Scholar
  26. First MB. Preserving the clinician-researcher interface in the age of RDoC: the continuing need form DSM-5/ICD-11 characterization of study populations. World Psychiatry. 2014;13(1):53–4.CrossRefGoogle Scholar
  27. Flint J, Kendler KS. The genetics of major depression. Neuron. 2014;81(3):484–503.CrossRefGoogle Scholar
  28. Fried EI, Nesse RM. Depression is not a consistent syndrome: an investigation of unique symptom patterns in the STAR*D study. J Affect Disord. 2015;172:96–102.CrossRefGoogle Scholar
  29. Fried EI, Nesse RM, Zivin K, Cuille C, Sen S. Depression is more than the sum-score of its parts: individual DSM symptoms have different risk factors. Psychol Med. 2014;44(10):2067–76.CrossRefGoogle Scholar
  30. Fried EI, Epskamp S, Nesse RM, Tuelinckx F, Borsboom D. What are ‘good’ depression symptoms? Comparing the centrality of DSM and non-DSM symptoms of depression in a network analysis. J Affect Disord. 2016;189:314–20.CrossRefGoogle Scholar
  31. Gaspesz R, Lamers F, Kent JM, Beekman ATF, Smit JH, van Hemert AM, Schoevers RA, Penninx BWJ. Longitudinal predictive validity of the DSM-5 anxious distress specifier for clinical outcomes in a large cohort of patients with major depressive disorder. J Clin Psychiatry. 2017;78(2):207–13.CrossRefGoogle Scholar
  32. Gehlert S, Song IH, Chang CH, Hartlage SA. The prevalence of premenstrual dysphoric disorder in a randomly selected group of urban and rural women. Psychol Med. 2009;39(1):129–36.CrossRefGoogle Scholar
  33. Greene GM. The relationship between depression and hopelessness: implications for current theories of depression. Br J Psychiatry. 1993;154:650–9.CrossRefGoogle Scholar
  34. Harald B, Gordon P. Meta-review of depressive subtyping models. J Affect Disord. 2012;139(2):126–40.CrossRefGoogle Scholar
  35. Heckers S, Barch DM, Bustillo J, Gaebel W, Gur R, Malaspina D, Owen MJ, Schultz S, Tandon R, Tsuang M, van Os J, Carpenter W. Structure of the psychotic disorders classification in DSM-5. Schizophr Res. 2013;150:11–4.CrossRefGoogle Scholar
  36. Hettema JM. The nosological relationship between generalized anxiety disorder and major depression. In: Goldberg D, Kendler KS, Sirovatka PJ, Regier DA, editors. Diagnostic issues in depression and generalized anxiety disorder: refining the research agenda for DSM-V. Washington: American Psychiatric Association; 2010. p. 15–39.Google Scholar
  37. Hoertel N, Lopez S, Peyre H, Wall MM, Gonzalez-Pinto A, Limosin F, Blanco C. Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using item response theory (IRT). Depress Anxiety. 2015;32(2):129–40.CrossRefGoogle Scholar
  38. Insel T. Director’s blog: transforming diagnosis. National Institute of Mental Health; 2013. Accessed 13 Dec 2013.
  39. Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Sanislow C, Wang P. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010;167(7):748–51.CrossRefGoogle Scholar
  40. Iovieno N, Tedeschini E, Bentley KH, Evins AE, Papakostas GI. Antidepressants for major depressive disorder and dysthymic disorder in patients with comorbid alcohol use disorders: a meta-analysis of place-controlled randomized trials. J Clin Psychiatry. 2011;72(8):1144–51.CrossRefGoogle Scholar
  41. Joiner TE Jr, Steer RA, Abramson LY, Alloy LB, Metalsky GI, Schmidt NB. Hopelessness depression as a distinct dimension of depressive symptoms among clinical and non-clinical samples. Behav Res Ther. 2001;39(5):523–36.CrossRefGoogle Scholar
  42. Judd LL, Akiskal HS. Delineating the longitudinal structure of depressive illness: beyond clinical subtypes and duration thresholds. Pharmacopsychiatry. 2000;33(1):3–7.CrossRefGoogle Scholar
  43. Kato TA, Hashimoto R, Hayakawa K, Kubo H, Watabe M, Teo AR, Kanba S. Multidimensional anatomy of ‘modern type depression’ in Japan: a proposal for a different diagnostic approach to depression beyond the DSM-5. Psychiatry Clin Neurosci. 2016;70(1):7–23.CrossRefGoogle Scholar
  44. Keller MC, Neale MC, Kendler KS. Association of different adverse life events with distinct patterns of depressive symptoms. Am J Psychiatry. 2007a;164(10):1521–9.CrossRefGoogle Scholar
  45. Keller J, Schatzberg AF, Maj M. Current issues in the classification of psychotic major depression. Schizophr Bull. 2007b;33(4):877–85.CrossRefGoogle Scholar
  46. Kendler JS, Neale MC, Kessler RC, Heath AC, Eaves LJ. Major depression and generalized anxiety disorder. Same genes, (partly) different environments? Arch Gen Psychiatry. 1992;49(9):716–22.CrossRefGoogle Scholar
  47. Kim YK, Choi J, Park SC. A novel bio-psychosocial-behavioral treatment model in schizophrenia. Int J Mol Sci. 2017;18(4):E734.CrossRefGoogle Scholar
  48. Klein DN, Schwartz JE, Roses S, Leader JB. Five-year course and outcome of dysthymic disorder: a prospective, naturalistic follow-up study. Am J Psychiatry. 2000;157(6):931–9.CrossRefGoogle Scholar
  49. Koukopoulos A, Sani G. DSM-5 criteria for depression with mixed features: a farewell to mixed depression. Acta Psychiatr Scand. 2014;129(1):4–16.CrossRefGoogle Scholar
  50. Koukopoulos A, Sani G, Koukopoulos AE, Manfredi Gm Pacchiaroti U, Giradi P. Melancholia, agitata and mixed depression. Acta Psychiatr Scand Suppl. 2007;433:50–7.CrossRefGoogle Scholar
  51. Koulopoulos A, Sani G, Ghaemi SN. Mixed features of depression: why DSM-5 is wrong (and so was DSM-IV). Br J Psychiatry. 2013;203(1):3–5.CrossRefGoogle Scholar
  52. Kupfer D, Regier D. Neuroscience, clinical evidence, and the future of psychiatric classification in DSM-5. Am J Psychiatry. 2011;168(7):672–4.CrossRefGoogle Scholar
  53. Leibenluft E. Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youth. Am J Psychiatry. 2011;168(2):129–42.CrossRefGoogle Scholar
  54. Lichtenstein P, Yip BH, Bjork C, Pawitan Y, Cannon TD, Sullivan PF, Hultman CM. Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. Lancet. 2009;373(9659):234–9.CrossRefGoogle Scholar
  55. Lish JD, me-Meenan S, Whybrow PC, Price RA, Hirschfeld R. The National Depressive and Manic-Depressive Association (DMDA) survey of bipolar members. J Affect Disord. 1994;31(4):281–94.CrossRefGoogle Scholar
  56. Maj M, Pirozzi R, Magliano L, Fiorillo A, Bartoli L. Phenomenology and prognostic significance of delusions in major depressive disorder: a 10-year prospective follow-up study. J Clin Psychiatry. 2007;68(9):1411–7.CrossRefGoogle Scholar
  57. Malhi G, Fritz K, Allwang C, Burston N, Cocks C, Harper M, Kearney B, Klug P, Meagher L, Mimnagh J, Purayil S, Rowe M, Samir H, Way R, Wilson C, Lyndon W. Agitation for recognition by DSM-5 mixed features specifier signals fatigue? Aust N Z J Psychiatry. 2015;49(6):499–501.CrossRefGoogle Scholar
  58. Marsiglia FF, Kulis S, Garcia PH, Permudez-Parasi M. Hopelessness, family stress, and depression among Mexican-heritage mothers in the southwest. Health Soc Work. 2011;36:7–18.CrossRefGoogle Scholar
  59. McGlinchey JB, Zimmerman M, Young D, Chelminski I. Diagnosing major depressive disorder VIII: are some symptoms better than others? J Nerv Ment Dis. 2006;194(10):785–90.CrossRefGoogle Scholar
  60. McIntyre RS, Soczynska JK, Cha DS, Woldeyohannes HO, Dale RS, Alsuwaidan MT, Gallaugher LA, Mansur RB, Muzina DJ, Carvalho A, Kennedy SH. The prevalence and illness characteristics of DSM-5 defined “mixed feature specifier” in adults with major depressive disorder and bipolar disorder: results from the international mood disorders collaborative project. J Affect Disord. 2015;172:259–64.CrossRefGoogle Scholar
  61. Moller HJ, Bandelow B, Bauer M, Hampel H, Herpertz SC, Soyka M, Barnikol UB, Lista S, Severus E, Maier W. DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequence—Part 1: General aspects and paradigmatic discussion of depressive disorders. Eur Arch Psychiatry Clin Neurosci. 2015;265(1):5–18.CrossRefGoogle Scholar
  62. Narrow WE, First MB, Sirovatka PJ, Regier DA. Age and gender considerations in psychiatric diagnosis: a research agenda for DSM-V. Washington: American Psychiatric Association; 2007.Google Scholar
  63. Nusslock R, Frank E. Subthreshold bipolarity: diagnostic issues and challenges. Bipolar Disord. 2011;13(7–8):587–603.CrossRefGoogle Scholar
  64. Ohayon MM, Schatzberg AF. Prevalence of depressive episodes with psychotic features in general population. Am J Psychiatry. 2002;159(11):1855–61.CrossRefGoogle Scholar
  65. Olbert CM, Gala GJ, Tupler LA. Quantifying heterogeneity attributable to polythetic diagnostic criteria: theoretical framework and empirical application. J Abnorm Psychol. 2014;123(2):452–62.CrossRefGoogle Scholar
  66. Østergaard SD, Jensen SOW, Bech P. The heterogeneity of the depressive syndrome: when number get serious. Acta Psychiatr Scand. 2011;124(6):495–6.CrossRefGoogle Scholar
  67. Østergaard SD, Bille J, Søltoft-Jensen H, Lauge N, Bech P. The validity of severity-psychosis hypothesis in depression. J Affect Disord. 2012a;140(1):48–56.CrossRefGoogle Scholar
  68. Østergaard SD, Rothschild AJ, Uggerby P, Munk-Jørgensen P, Bech P, Mors O. Considerations on the ICD-11 classification of psychotic depression. Psychother Psychosom. 2012b;81(3):135–44.CrossRefGoogle Scholar
  69. Papadimitriou GN, Dikeous DG, Daskalopoulou EG, Soldatos CR. Co-occurrence of disturbed sleep and appetite loss differentiates between unipolar and bipolar depressive episodes. Prog Neuro-Psychopharmacol Biol Psychiatry. 2002;26(6):1041–5.CrossRefGoogle Scholar
  70. Park SC, Lee HY, Lee DW, Hahn SW, Park SH, Kim YJ, Choi JS, Lee HS, Lee SI, Na KS, Jung SW, Shim SH, Choi J, Paik JW, Kwon YJ. Knowledge and attitudes of 851 nursing personnel toward depression in general hospitals of Korea. J Korean Med Sci. 2015;30(7):953–9.CrossRefGoogle Scholar
  71. Park SC, Kim JM, Jun TY, Lee MS, Kim JB, Yim HW, Park YC. How many different symptom combinations fulfill the diagnostic criteria for major depressive disorder? Results from the CRESCEND study. Nord J Psychiatry. 2017;71(3):217–22.CrossRefGoogle Scholar
  72. Pergi G, Angst J, Azorin JM, Bowden CL, Vieta E, Young AH, The BRIDGE-II-Mix Study Group. Relationships between mixed features and borderline personality disorder in 2811 patients with major depressive episode. Acta Psychiatr Scand. 2015;133:133–43.CrossRefGoogle Scholar
  73. Pies RW. The bereavement exclusion and DSM-5: an update and commentary. Innov Clin Neurosci. 2014;11(7–8):19–22.PubMedPubMedCentralGoogle Scholar
  74. Rao U. DSM-5: disruptive mood dysregulation disorder. Asian J Psychiatry. 2014;11:119–23.CrossRefGoogle Scholar
  75. Rasic D, Hajek T, Alda M, Uher R. Risk of mental illness in off-spring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull. 2013;40(1):28–38.CrossRefGoogle Scholar
  76. Rhebergen D, Graham R. The re-labelling of dysthymic disorder to persistent depressive disorder in DSM-5: old wine in new bottle? Curr Opin Psychiatry. 2014;27(1):27–31.CrossRefGoogle Scholar
  77. Rosenblat JD, McIntyre, et al. Treatment recommendations for DSM-5-defined mixed features. CNS Spectr. 2016;22:147–54.CrossRefGoogle Scholar
  78. Rosenman S, Nasti J. Psychiatric diagnoses are not mental processes: Wittgenstein on conceptual confusion. Aust N Z J Psychiatry. 2012;46(11):1046–52.CrossRefGoogle Scholar
  79. Rubio JM, Markowitz JC, Alegria A, Perez-Fuentes G, Liu SM, Lin KH, Blanco C. Epidemiology of chronic and non-chronic major depressive disorder: results from the national epidemiologic survey on alcohol and related conditions. Depress Anxiety. 2011;28(8):622–31.CrossRefGoogle Scholar
  80. Stringaris A. Irritability in children and adolescents: a challenge for DSM-5. Eur Child Adolesc Psychiatry. 2011;20(2):61–6.CrossRefGoogle Scholar
  81. Stringaris A, Goodman R. Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry. 2009a;48(4):404–12.CrossRefGoogle Scholar
  82. Stringaris A, Goodman R. Three dimensions of oppositionality in youth. J Child Psychol Psychiatry. 2009b;50(3):216–23.CrossRefGoogle Scholar
  83. Sveinsdottir H, Backstrom T. Menstrual cycle symptom variation in a community sample of women using and not using oral contraceptives. Acta Obstet Gynecol Scand. 2000;79:757–64.CrossRefGoogle Scholar
  84. Targum SD, Suppes T, Pendergrass JC, Lee S, Silva R, Cucchiaro J, Loebel A. Major depressive disorder with subthreshold hypomania (mixed features): clinical characteristics of patients entered in a multiregional, placebo-controlled study. Prog Neuro-Psychopharmacol Biol Psychiatry. 2016;68:9–14.CrossRefGoogle Scholar
  85. Uher R, Perlis RH, Henisberg N, Zobel A, Rietschel M, Mors O, Hauser J, Dernovseak Z, Souery D, Bajs M, Maier W, Aitchison KJ, Farmer A, McGuffin P. Depression symptom dimensions as predictors of antidepressant treatment outcome: replicable evidence for interest-activity symptoms. Psychol Med. 2012;42(5):967–80.CrossRefGoogle Scholar
  86. Uher R, Payne JL, Pavlova B, Perlis RH. Major depressive disorder in DSM-5: implications for clinical practice and research of changes from DSM-IV. Depress Anxiety. 2014;31(6):459–71.CrossRefGoogle Scholar
  87. Vieta E, Philips ML. Deconstructing bipolar disorder: a critical review of its diagnostic validity and a proposal for DSM-V and ICD-11. In: Tamminga CA, Sirivatka PJ, Regier DA, van Os J, editors. Deconstructing psychosis: refining the research agenda for DSM-V. Washington: American Psychiatric Association; 2010. p. 45–57.Google Scholar
  88. Vilgis V, Chen J, Silk TJ, Cunnington R, Vance A. Frontoparietal function in young people with dysthymic disorder (DSM-5: persistent depressive disorder) during spatial working memory. J Affect Disord. 2014;160:34–42.CrossRefGoogle Scholar
  89. von Wolff A, Holzel LP, Westphal A, Harter M, Kriston L. Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: a systematic review and meta-analysis. J Affect Disord. 2013;144(1–2):7–15.CrossRefGoogle Scholar
  90. Whooley O, Horowitz AV. The paradox of professional success: grand ambition, furious resistance, and the derailment of the DSM-5 revision process. In: Paris J, Phillips J, editors. Making the DSM-5. New York: Springer; 2013. p. 75–94.CrossRefGoogle Scholar
  91. Yonkers JA, Gotman N, Smith AM, Forray A, Belanger K, Brunetto WL, Lin H, Burkman RT, Zelop CM, Lockwod CJ. Does antidepressant use attenuate the risk of a major depressive episode in pregnancy? Epidemiology. 2011;22(6):848–54.PubMedPubMedCentralGoogle Scholar
  92. Zimmerman M, Galione JN, Chelminski I, McGlinchery JB, Young D, Dalrymple K, Ruggero CJ, Witt CF. A simpler definition of major depressive disorder. Psychol Med. 2010;40(3):451–7.CrossRefGoogle Scholar
  93. Zimmerman M, Emmert-Aronson BO, Brown TA. Concordance between a simpler definition of major depressive disorder and Diagnostic and Statistical Manual of Mental Disorders, fourth edition: an independent replication in an outpatient sample. Compr Psychiatry. 2011;52(3):261–4.CrossRefGoogle Scholar
  94. Zimmerman M, Chelminski I, Young D, Dalrymple J, Matinez JH. A clinically useful self-report measure of the DSM-5 mixed features specifier of major depressive disorder. J Affect Disord. 2014;168:357–62.CrossRefGoogle Scholar
  95. Zimmerman M, Ellison W, Young D, Chelminski I, Dalrymple K. How many different ways do patients meet the diagnostic criteria for major depressive disorder. Compr Psychiatry. 2015;56:29–34.CrossRefGoogle Scholar
  96. Zisook S, Corruble E, Duan N, Iglewicz A, Karam EG, Lanouette N, Lebowitz B, Pies R, Reynolds C, Seay K, Katherine SM, Simon N, Young IT. The bereavement exclusion and DSM-5. Depress Anxiety. 2012;29(5):425–43.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of PsychiatryInje University College of Medicine and Haeundae Paik HospitalBusanSouth Korea
  2. 2.Department of Psychiatry, College of MedicineKorea UniversitySeoulSouth Korea
  3. 3.Department of Psychiatry, College of MedicineKorea University Ansan HospitalAnsanSouth Korea

Personalised recommendations