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

  • Seon-Cheol Park
  • Yong-Ku Kim
Chapter

Abstract

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.

Keywords

Depression DSM-5 Humanistic approach Operational diagnosis Transnosological specifiers 

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© 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

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