Depression: Current Conceptual Trends

Abstract

This chapter discusses the current conceptual trends in major depression. Our field has been divided on continuing with the legacy of DSM and a more theoretically driven, biologically based, phenomenologically linked diagnostic approach to depression. With the current approach requiring five out of eight primary criteria to diagnose major depression, one can imagine the number of combinations that could exist. This likely means that we have been diagnosing and studying different disease processes under one heading. No wonder that our treatments have not been that successful. While there may be multiple reasons to precipitate a first depression episode, whether it is a social stressor, a genetic loading, an acute medical illness, or an exposure to a toxin, it appears that over time, and with repeated relapses, patients progress to become more treatment resistant. This backdrop represents a more homogeneous group of patients where we are more likely to uncover a common underlying pathophysiology. The challenge would be to generalize it back to the predominant depressed subtypes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(chapter)