Through a Glass Darkly: The Disutility of the DSM Nosology of Depressive Disorders

Abstract

Objective: To demonstrate that the dimension-weighted DSM-IV model for classifying the depressive disorders lacks utility. Method: The logical flaws in classifying the depressive disorders with any severity-based model (which underpin both the DSM-IV and ICD-10 systems) are noted. Integral definitional limitations to the DSM-IV definition of key depressive disorders are identified. It is argued that the DSM-IV classificatory system lacks utility for providing information on etiology and preferential management strategies. An alternative subtyping model is considered. Results: It is asserted that, in practice, the DSM-IV model and criteria lack explanatory power and compromise research and clinical practice. Conclusions: It is hoped that this article evokes wider debate about modelling and classifying the depressive disorders.