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MDD DSM-5 sub-workgroup report


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The major depression subworkgroup is part of the mood disorders workgroup.

http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/DSM-V-Work-Group-Reports/Mood-Disorders-Work-Group-Report.aspx

Of note:

They're trying to figure out what to do major depression that includes subthreshold manic symptoms. It could mean that up to 30% of people dx'd with major depression could be reclassified as bipolar. So they're hoping to find a boundary that indicates when to start treating for bipolar instead of major depression.

They're also looking at subthreshold depressive symptoms that predict disability and suicide risk.

From the report:

The issue is where and how to draw a boundary of caseness so that community rates of depression don’t soar to unbelievable levels

Which sounds like they're drawing boundaries based on how many people they think should be depressed. So maybe they'll pick, a certain percentage, and then alter the symptoms they count toward a diagnosis until they have a diagnosis that picks out that percent of the population? I wonder what they'll base it on. There's a lot of room there for a "Well, when *I* was in med school, we didn't have all this..." approach.

They also mention briefly in the childhood and adolescent working group report that they may have new criteria for pediatric MDD:

http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/DSM-V-Work-Group-Reports/Childhood-and-Adolescent-Disorders-Work-Group-Report.aspx

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I tried to PM this to resonance but got an error that said I could not so...

I've seen you're posting a lot about the work being done on the DSM-V and I wonder if you've found anything regarding Depressive PD. My tdoc said it would likely be added but there is some controversy surrounding it and I just wondered if you'd found/read anything about it. Thanks.

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I tried to PM this to resonance but got an error that said I could not so...

I've seen you're posting a lot about the work being done on the DSM-V and I wonder if you've found anything regarding Depressive PD. My tdoc said it would likely be added but there is some controversy surrounding it and I just wondered if you'd found/read anything about it. Thanks.

See the post on the PD board. It sounds like the whole personality disorder category is really an unsettled mess.

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I tried to PM this to resonance but got an error that said I could not so...

I've seen you're posting a lot about the work being done on the DSM-V and I wonder if you've found anything regarding Depressive PD. My tdoc said it would likely be added but there is some controversy surrounding it and I just wondered if you'd found/read anything about it. Thanks.

See the post on the PD board. It sounds like the whole personality disorder category is really an unsettled mess.

Thanks, guess I missed it with the state I'm in. I really did try to PM and it wouldn't let me. Maybe it is full. Dunno. Will check out what you said.

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I tried to PM this to resonance but got an error that said I could not so...

I've seen you're posting a lot about the work being done on the DSM-V and I wonder if you've found anything regarding Depressive PD. My tdoc said it would likely be added but there is some controversy surrounding it and I just wondered if you'd found/read anything about it. Thanks.

See the post on the PD board. It sounds like the whole personality disorder category is really an unsettled mess.

Thanks, guess I missed it with the state I'm in. I really did try to PM and it wouldn't let me. Maybe it is full. Dunno. Will check out what you said.

I just read the above posts, and I find the target specific subject most interesting! My interpretation (from my experience from multiple psychologists,

and psychiatrists, going back to 1991, when the DSM-IIIR, was still being used, and 1994, going forward with the DSM-IV, I was first given the diagnosis of

"Depressive Personality Disorder", but, for insurance purposes, (so the medical

practitioner would get paid, I was labeled with "Dysthymic Disorder" which, of course switched the diagnosis from "Axis II" to a "Axis I" . I felt confused with

the switch, my counselor, from the early to mid 1990's, told me "it was primarily the same thing", for me to not "frett over it". The DSM-IV states that "Dysthymic

Disorder" A. "depressed mood for most of the day, for at least 2 years" (adults)

& in children & adolescents, for at least 1 year. B. At least 2 or more of 6 listed

behavior traits C. the person has never been without the symptoms criteria A & B for more than 2 months at a time. D. No MDD (Major Depressive Disorder) has been present during the first 2 yrs. There are other more minor criteria exceptions, & qualifer's, four more, E, F, G, H. but it may sound redundant to go over every thing, so I will try to stay on topic. (I was technically given the Dysthymic Disorder, even earlier, when I was in my 20's, but back then, the DSM

used classified "Dysthmic Disorder as Depressive Neurosis". In the past 10 yrs, I have been told by several clinical people, (Ph.D's & M.D.'s ie psychiatrists) that I really have a "Personality Disorder, NOS", partly because, "Depressive Personality Disorder" at least since 1994, if not earlier, is classified in DSM-IV as a "Criteria Set and Axes provided for further study" just like several others from DSM-III or DSM-III R , Passive Aggressive PD. Due to some negative situational factors, my

diagnosis has "changed from time to time" in the short run, with the so-called,

"Double Depression" (Dysthmic Disorder overlapped with a active Major Depressive Disorder episode) examples, unexpected job firing, unexpected Divorce, etc. and/or with "Seasonal Affective Disorder". The distinction between

Dysthmic Disorder and Depressive Personality Disorder" (from DSM-IV states...

quote "by their emphasis on cognitive, interpersonal, & intrapsychic personality traits". Personally, (my interpretation), and my now (ex-wive's evaluation.....

RN Case Manager.....is that I have been "depressed all of my life", and, I tend to agree with this, I'm talking going all the way back to childhood, which, seems to support the "Depressive Personality Disorder" diagnosis, also, because, after, I'd say 20 years of many, many ethical pharmaceutial's, from old school tri-cycle anti-depressants, 1/2 dozen, to, the whole range of SSRI's, SNRI's, and even, the tetracycle anti-depressants, with, and without Lithium, as a "booster", I have had

only a limited success with any meds for complete remission.....after 9 years of

private psychotherapy, from MSW's to Ph.D's using DBT, and, Cognitive behavioral Therapy, I increasingly relate to "Refractory Treatment Resistant Depression" . I was always told that there is "no cure for a Axis II Personality Disorder", that no Insurance Company will pay for the that kind of diagnosis, although Personality Disorders exist for sure, but that "Personality Disorders" can

be "managed" with psychotherapy for one's awarneness, one's significant effect

on other people, and sometimes, (as in my case) some prescription psychotrophic medications, are still dispensed, for a variety of reasons, especially

if one has a co-morbid diagnosis, (multiple bona-fide extra DSM-IV Axis I diagnosis's that "overlap". When is the DSM-V projected to be released? Does anyone out in cyberspace know? A great source for very detailed, and intense case studies, on all of the "official DSM-IV" Personality Disorders (11)plus the additional PD's that are being "further studied & researched" (4) being, Depressive PD, Sadistic PD, Negativistic/PassiveAggressive PD, & Masochistic PD, I'd recommend this 818 page book "Disorders of Personality DSM-IV and Beyond" by

Theodore Millon Ph.D, (1996) ISBN #0-471-01186-X 2nd edt. publisher Wiley-Interscience. Dr. Millon is a Professor of Psychiatry at Harvard University, and a

Professor of Psychology at University of Miami, Fla. P.S. "I think I found my answer from the APA.....projected date for the new DSM-V is scheduled for May of 2012.

Dx: ADHD 314.01, GAD 300.02 with OCD traits, Personality Disorder NOS 301.9, Dissociative Disorder, NOS, 300.15

Current Meds: Dexedrine Spansule 15mg. Adderall 10 mg. upon arising,

Adderall 10mg. before 5PM, Ambien 10 mg. 1 hr prior to bedtime, Desyrel (Trazodone) 100 mg. @bedtime, can

titrate Trazodone up to 150 mg. if needed.

Meds I hate (tried, but discontinued)

Risperdal, Seroquel, Abilify, Lamictal,

Neurontin, Lithium.

Edited by LanceLarson
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