Major depressive disorder journey in DSM

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Major depressive disorder journey in DSM

The condition officially became part of the third edition of Diagnostic and Statistical Manual of Mental Disorders (DSM III) in 1980. 

DSM-I

DSM-I identified depression (which is referred to as “Depressive Reaction”) as the following:

The stress of the reaction is quelled and is subsequently eased, through depression and self-doubt. The trigger is an actual situation, usually caused by a loss suffered by the patient. It is often accompanied by feelings of guilt over past mistakes of actions. The reaction of a patient in such situations is based on the intensity of the patient’s conflicting feelings towards the loss (love and possession) and the actual circumstances surrounding the loss.

Major depressive disorder journey in DSM
Major depressive disorder journey in DSM

This definition, along with other ones in the DSM-I is focused on the dynamic (loss and guilt, ambivalence,) which could lead to depression. It does not offer any guidelines on how to identify or quantify depressive symptoms. The definitions of the other categories that are not organic in the manual–psychotic and personality disorders — reflected the same basic fundamentals. There was no detailed description of the symptoms. On the other hand, many were influenced by psychodynamic theories regarding how they came about.

DSM-II

In DSM-II this condition is known as Manic-depressive disorder or depressed type (Manic-depressive psychosis or depressed type)

This condition is comprised of depressive episodes. The episodes are characterized by severe depression as well as motor and mental slowing that can lead to a state of stupor. Perplexity, anxiety, and agitation can be evident. When hallucinations, dreams, and thoughts (usually from guilt, or hypochondriacal or paranoid thoughts) occur and are attributed to the predominant mood disorder. Since this is an underlying disorder of mood it is distinct from Psychotic depressive reaction which is more easily attributable to stress. Some cases that aren’t properly labeled in the form of “psychotic depression” should be classified as such instead of under Psychotic depression.

DSM-III

In DSM-III this disorder is referred to as Major Depression. It can be explained with or without melancholia-related features. Major depression is categorized as dysthymia, which is located in Axis 1.

DSM III R

The DSM III R Major depression is differentiated from dysthymia.

DSM-IV

Depression disorders were classified as bipolar disorders and other related disorders. In DSM-IV it was an exclusion criterion for major depressive episodes. This was applied to depression symptoms that lasted less than two months following the loss of the loved one (i.e. an exclusion for bereavement).

DSM V

In DSM-IV it was an exclusion criterion to define major depressive episodes that were used to describe depressive symptoms that lasted less than two months after the death of loved ones (i.e. being excluded from bereavement). The exclusion was removed in DSM-5 due to a variety of reasons.

One of the most significant changes introduced in DSM-5 has been the division of the section on mood disorders into two sections that focus on bipolar and related disorders, and the other one on depression disorders. The bipolar unit and other related disorders are located between the section on schizophrenia and psychotic disorder on one hand and the section on depression disorders on the opposite side.

Disorder of mood that is disruptive has been included within DSM V to avoid misdiagnosis of bipolar disorder in children. The inclusion of it in this chapter is a reflection of the observation that children suffering from this type of symptom generally develop a unipolar depressive disorder or anxiety disorder as opposed to bipolar disorders as they grow into the age of adolescence and into adulthood.

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