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Cited by 77Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionMental Health Research Topics

Diagnosing Major Depressive Disorder VIII: Are Some Symptoms Better Than Others?

McGlinchey, Joseph B., Zimmerman, Mark, Young, Diane, Chelminski, Iwona·2006·Journal of Nervous & Mental Disease
DOI 10.1097/01.nmd.0000240222.75201.aa
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Abstract

The present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project examined whether symptoms that are not part of the DSM-IV definition of major depressive disorder (MDD) are better at discriminating depressed from nondepressed patients than the current criteria. Symptoms assessed included diminished drive, helplessness, hopelessness, nonreactive mood, psychic anxiety, somatic anxiety, subjective anger, and overtly expressed anger. A total of 1538 psychiatric outpatients were administered a semistructured diagnostic interview. We inquired about all of the symptoms of depression for all patients. Diminished drive exhibited stronger performance in differentiating MDD from non-MDD relative to all DSM-IV criteria except depressed mood, reduced interest/pleasure, and impaired concentration/indecisiveness. A compound criterion combining diminished drive with loss of energy was endorsed by nearly all MDD patients. Helplessness and hopelessness, when combined into a single criterion, performed more strongly than some of the DSM-IV criteria. Lack of reactivity, anxiety, and anger symptoms failed to differentiate more strongly than current DSM-IV criteria. The implications of these results for revising the diagnostic criteria for major depression are discussed.

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  • Hopelessness, included in the ICD-11 criteria for a depressive episode but not in the DSM-5 criteria for major depression, was found to perform more strongly than approximately half of the DSM symptoms in differentiating depressive from non-depressive subjects.

    “The list includes one symptom (hopelessness) that is not present in the DSM-5 criteria for major depression, but which was found to perform more strongly than approximately half of the DSM symptoms in differentiating depressive from non-depressive subjects [47].”

    From Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies (2020) · cites this paper as [47]

  • The additional symptom in ICD-11 is hopelessness about the future, included because of empirical evidence that it performs more strongly than about half of other depressive symptoms in differentiating depressed from non-depressed individuals.

    “The additional symptom in the ICD-11 is hopelessness about the future, which was included because of empirical evidence that it performs more strongly than about half of the other depressive symptoms in differentiating depressed from non-depressed individuals 46 .”

    From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [46]

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Authors
McGlinchey, J. B., Zimmerman, M., Young, D., & Chelminski, I.
Affiliations
Brown University (US)
ORCID
Zimmerman, Mark
Venue
Journal of Nervous & Mental Disease
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-10
Volume
194
Issue
10
Pages
785-790
ISSN
0022-3018 (ISSN-L)
DOI
10.1097/01.nmd.0000240222.75201.aa
OpenAlex
W2036502423
Cited by
77
References
31
Citations by year
2026: 3 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 3 · 2017: 2 · 2015: 6 · 2014: 4 · 2013: 4 · 2012: 4
FWCI
4.19
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Nervous and Mental Disease (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
major depressive disorder, diagnostic criteria, DSM-IV, helplessness, hopelessness, psychic anxiety, somatic anxiety, anger, energy loss, psychiatric outpatients, diagnostic accuracy
MeSH terms
Affective Symptoms, Ambulatory Care, Major Depressive Disorder, Diagnosis, Differential, Female, Humans, Male, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, Odds Ratio, Diagnostic and Statistical Manual of Mental Disorders

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