Excerpt from: New York Times (click for full article)
First, the new volume revises some of the criteria for major
depressive disorder. The D.S.M. IV (among other changes, the new manual
swaps Roman numerals for Arabic ones) set out a list of symptoms that
over a two-week period would trigger a diagnosis of major depression:
either feelings of sadness or emptiness, or a loss of interest or
pleasure in most daily activities, plus sleep disturbances, weight loss,
fatigue, distraction or other problems, to the extent that they impair
someone’s functioning.
Traditionally, depression has been
underdiagnosed in older adults. When people’s health suffers and they
lose friends and loved ones, the sentiment went, why wouldn’t they be
depressed? A few decades back, Dr. Kupfer said, “what was striking to me
was the lack of anyone getting a depression diagnosis, because that was
‘normal aging.’” We don’t find depression in old age normal any longer.
But
critics of the D.S.M. 5 now argue that depression may become
overdiagnosed, because this version removes the so-called “bereavement
exclusion.” That was a paragraph that
cautioned against diagnosing depression in someone for at least two
months after loss of a loved one, unless that patient had severe
symptoms like suicidal thoughts.
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