Depression too often reduced to a checklist of symptoms

http://www.eurekalert.org/pub_releases/2015-10/kl-dto102315.php

Public Release: 23-Oct-2015
Depression too often reduced to a checklist of symptoms
KU Leuven

How can you tell if someone is depressed? The Diagnostic and Statistical Manual of Mental Disorders (DSM) - the 'bible' of psychiatry - diagnoses depression when patients tick off a certain number of symptoms on the DSM checklist. A large-scale quantitative study coordinated at KU Leuven, Belgium, now shows that some symptoms play a much bigger role than others in driving depression, and that the symptoms listed in DSM may not be the most useful ones.

To diagnose depression, psychiatrists typically tally up the number of depression symptoms that patients report in questionnaires. It does not matter which of the symptoms these patients have, as long as they have a certain number of them.

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"If you think of depression as a network of interacting symptoms, one symptom can cause another", Fried clarifies. "For instance, insomnia may lead to fatigue, which in turn may cause concentration problems that feed back into insomnia. This example of a vicious circle shows that the specific symptoms patients report, and their interactions, can be of crucial clinical importance".

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In the study, the two main DSM symptoms - sad mood and decreased interest or pleasure - ranked among the top 5 in terms of centrality. But the researchers also found that DSM symptoms such as hypersomnia, agitation, and weight change are not more central than other common depression symptoms such as pessimism and anxiety.

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