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

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Understanding Depression

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.

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  1. Department of Psychiatry, Inje University College of Medicine and Haeundae Paik Hospital, Busan, South Korea

    Seon-Cheol Park

  2. Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea

    Yong-Ku Kim

  3. Department of Psychiatry, College of Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi Province, South Korea

    Yong-Ku Kim

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Park, SC., Kim, YK. (2018). Depression in DSM-5: Changes, Controversies, and Future Directions. In: Kim, YK. (eds) Understanding Depression. Springer, Singapore. https://doi.org/10.1007/978-981-10-6577-4_1

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