M Zimmerman

..The results did not indicate that the alternative diagnostic algorithm improved validity, and, depending on the threshold used, could result in false negative diagnoses...

..Examination of the frequency of specific symptoms suggests that the choice of scale might impact on which residual symptoms are considered the most frequent in treatment remitters...

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..Possible reasons for the low prevalence of PG in our sample are discussed...

..Among the HDRS remitters, we compared the demographic and clinical characteristics of patients who did and did not consider themselves to be in remission...

..In this context, I consider the controversy over whether the diagnostic threshold for bipolar disorder should be lowered...

..Such inappropriate use of screening scales risks distorting perceptions about many facets of BD, from its prevalence to its consequences...

..In the present report from the MIDAS project, we examined the level of current psychosocial morbidity in depressed patients identified as being in remission according to different thresholds on the 17-item HAM-D...

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..The implications of these results for revising the diagnostic criteria for major depression are discussed...

..The implications of these results for constructing diagnostic criteria, and for developing measures to assess the severity of depression, are discussed...

..Thus, the focus in the series is on clinical utility rather than validity...

..These findings support the validity of a self-report depression questionnaire as an index of remission status among treatment responders...

..The goal of the present study was to replicate these findings in another large sample of psychiatric out-patients and to extend the findings to other patient samples...

..This suggests that current symptom-based definitions of remission might be too narrow...

..In the present report from the MIDAS project, we examined whether there was a particular diagnostic profile associated with bipolar disorder overdiagnosis...

..This measure could make it more feasible to conduct effectiveness studies in clinical practice...

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..The goal of the present study was to determine psychiatrists' reported use of the DSM-IV criteria for MDD to diagnose depression and to compare their use to the use by nonpsychiatrist physicians...

..Thus, the results suggest that depressed outpatients who had previously been overdiagnosed with bipolar disorder were more chronically and severely ill than depressed outpatients who had not been overdiagnosed...

..The PDSQ's anxiety disorder subscales have high sensitivity and negative predictive value thereby indicating that the scale could function well as a screening instrument in depressed patients...

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..This suggests that the diagnostic criteria for MDD can be simplified to a straightforward symptom count without reference to the necessity of low mood or loss of interest or pleasure...

..Thus, as a group, personality disorders are among the most frequent disorders treated by psychiatrists...

..In the present report we examined the frequency of DSM-IV Axis I diagnostic co-morbidity in psychiatric out-patients...

..The goal of the present report is to estimate the proportion of relapse attributable to the loss of true drug response versus a loss of placebo response...

..In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we empirically examined whether bipolar disorder is overdiagnosed...

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..Thus, the results of this large validation study of the CUDOS shows that it is a reliable and valid measure of depression that is feasible to incorporate into routine clinical practice...

..These results suggest that there is as much heterogeneity among patients who are typically considered to be in remission as there is among responders. This supports recommendations to lower the cutoff on the HAM-D to define remission...

..We discuss using improvement in the clinical utility, rather than validity of diagnostic criteria, as the basis for making revisions in the nomenclature...

..The results thus do not support DSM-IV's implicit assumption of no difference between depressed patients who do and do not report low mood. The alternative ways this might be addressed in future editions of the DSM are discussed...

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..This has implications for the future consideration of genetic markers as diagnostic criteria...

..We discuss issues related to the possible use of a self-administered depression symptom scale as a diagnostic criterion...

..It is likely that the results of a study of the impact of the DSM-IV depression exclusion criteria will depend on where the study is conducted. The potential influence of different settings on diagnostic exclusion is discussed...

..Because some of the sizes of the diagnostic groups in the initial report were modest, it is important to determine whether the recommended cut-off scores to screen for psychiatric disorders remained the same in a replication study...

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..Limitations: The study was conducted with patients in a single outpatient clinical practice rather than participants of a multi-site trial...

..Implications of these findings for DSM-5 are discussed...

..The authors examined the validity of this remaining hierarchical relationship between mood and anxiety disorders...

..AETs tend to include the subset of depressed individuals with moderate to severe MDD and exclude a significant proportion of depressed patients who have mild MDD. The implications of these findings are discussed...

..Patient acceptance of the RDQ was compared with that of the Quick Inventory of Depressive Symptomatology (QIDS), the instrument used to measure outcome in the Sequenced Treatment Alternatives to Relieve Depression study...

..diagnosis? and (2) How does the 3-point dimensional scoring convention compare to the 5-point system proposed for DSM-5 and to a criterion count approach in which the dimensional score represents the sum of the number of criteria present?..

..We reviewed the literature on the MDQ's performance to assess its utility as a screening instrument...

..In the present study, we examined the frequency of diagnostic comorbidity in psychiatric outpatients presenting for treatment of nonbipolar major depressive disorder (MDD) and patients' desire for treatment for the comorbid disorders...

..This study estimated the proportion of depressed patients treated in routine clinical practice who would meet standard inclusion/exclusion criteria for an efficacy trial...

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..In the present report, we describe the diagnostic performance (sensitivity, specificity, and positive and negative predictive values) of the PDSQ in an outpatient setting...

..The goal of this study was to determine which axis I psychiatric disorders motivate patients to seek treatment...

..The authors determined the frequency of anxiety disorders in a large group of depressed outpatients seeking treatment...

..The purpose of this study was to examine the reliability and validity of a new multidimensional screening instrument for 13 DSM-IV Axis I disorders...

..This study examined the influence of assessment method on the diagnosis of borderline personality disorder...

..In the present report from the Rhode Island Methods to Improve Diagnosis and Services project, we examine whether an association exists between psychotic subtyping of major depressive disorder and PTSD...

..In psychiatric outpatients with a principal diagnosis of MDD psychiatrists underrecognize anxiety disorder comorbidity for which patients want treatment...

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..This study derived a cutoff on a self-report depression questionnaire corresponding to the most widely used definition of remission (a score < or =7 on the 17-item Hamilton Depression Rating Scale)...

..The results also underscore that wide variation exists in the bias toward diagnosing bipolar disorder, even after controlling for differences in prevalence among samples...

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..In the absence of replicated empirical research guiding the selection of antidepressants, it is of interest to examine what factors psychiatrists consider when prescribing antidepressants...

..The cut-offs used to define remission from depression considerably influence the percentage of patients considered to be in remission. Lower cut-off scores than those most commonly used to define remission appear to be more valid...

..Receiver Operating Characteristic curves were plotted for each PDSQ subscale for both patient groups, and all areas under the curve were significant and similar in the two groups...

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..This raises the intriguing possibility of developing a combined screening scale/educational instrument that can be formatted as a brochure and thus placed in clinicians' waiting rooms, thereby facilitating use of the measure...

..The goal of the present study was to establish an empirically based cutoff on the MADRS for defining remission...

..Sub-typing of borderline patients by the number of criteria met provides a limited explanation for heterogeneity within BPD patients...

..Results suggest that perhaps these fears could be added to the SCID screening question to capture individuals missed by the SCID screening question and to provide more comprehensive information for treatment purposes...

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..Our results thus support the use of a lower cutoff on the HRSD than has been traditionally used to define remission...

..Taken together, these results generally do not support combining diagnostic orphans to individuals with alcohol abuse...

..The present study contrasted the rates and severity of depressive symptoms in outpatients diagnosed with PMD vs NMD...

..The present study assessed the social and work impairment associated with bipolar II disorder and whether these are more or less severe than those associated with bipolar I disorder or major depressive disorder...

..Results suggest that future treatments adapted for comorbid MDD and SAD perhaps should target work functioning and a broad range of social fears...

..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...

..Future studies employing a control group will be important to examine the extent of the response to nonspecific factors of treatment...

..Our results indicate that practitioners are making unique recommendations based on comorbid anxiety diagnoses, but outcome studies are now needed to determine the most effective treatment methods for this patient population...

..However, the report also underscores the difficulties in identifying a set of clinical criteria that clearly delineates between full PTSD and subthreshold PTSD...

..None of the hypotheses were supported, thereby suggesting that the comorbidity between PTSD and MDD is not an artifact of symptom overlap...

..However, previous research has not systematically explored the potential effects of the psychotic subtyping of MDD and comorbid PTSD...

..It remains unclear whether these reports represent true psychosis or culturally influenced idioms of distress...

..The results can also be used for normative comparisons in which posttreatment group mean scores are compared with mean scores from normative samples...

..The TRAQ can be administered by non-MDs as a reliable measure for collecting standardized information regarding antidepressant treatment history via patient interview...

..The manner by which a user might choose the appropriate scale-scoring method for case identification is discussed...

..However, most past research on PMD has been conducted in inpatient hospital samples, and relatively little is known about PMD patients presenting for treatment in the community specifically...

..The results of recent work on the Psychiatric Diagnostic Screening Questionnaire (PDSQ) are summarized...

..In addition to the need for further replication and clarification, these results have implications for the assessment and diagnosis of major depressive disorder. Suggestions for several additional avenues of research are discussed...

..It is unclear whether personality pathology is independently associated with the atypical features subtype...

..It remains unclear how much various factors contribute to the placebo response...

..It is concluded that although early age of onset is predictive of BPD, BPD is not a universal feature of early-onset MDD...

..This study evaluated the clinical and sociodemographic features associated with various degrees of concurrent comorbidity in adult outpatients with nonpsychotic major depressive disorder (MDD)...

..No gender differences were found in degree of overall impairment. These results suggest that male and female patients with BPD, although equally distressed, present with different lifetime patterns of impulse-related disorders...

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