Depression: Common Mood Disorder but Is It Over-diagnosed?

Patients who have been diagnosed with depression know that they are not alone. In fact, far from it. The leading cause of disability for patients between the ages of 15-44, depression affects nearly 15 million American adults. But here’s the surprising part: According to a recent study, over 60% of a selected pool of these patients did not actually meet the 12-month definition from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).


A team of researchers from Johns Hopkins University’s Bloomberg School of Public Health investigated a sample of 5,639 adult patients who had been determined by their providers to have depression. Only 38.4% of these adults actually met the criteria of having the following symptoms:


Depressed mood plus five of the following (remembered by the mnemonic SIG E CAPS)


Sleep changes (either hypersomnia or insomnia)


Interest (loss of interest in previously enjoyable activities)


Guilt, feelings of


Energy, decreased


Concentration, decreased


Appetite (either increased or decreased)


Psychomotor retardation or agitation


Suicidal ideation


The symptoms must be a change from the patient’s baseline, affect patient’s functional abilities (social, occupational, educational), and persist for at least two weeks continuously.


In the study, which appears in the April 2013 issue of Psychotherapy and Psychosomatics, adults 35-49 and 65+ years were less likely to meet the criteria than were adults in the 18-25 years group. About 6 out of 7 elderly patients did not satisfy the DSM-IV definition.


A majority of the total patients, including those who did not satisfy the definition, were medicated with anti-depressants.

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