Psychopathology and classification of depressive disorders

Abstract

Depressive disorders are a heterogeneous group of conditions in terms of their etiology, symptom composition and outcome, which has resulted in difficulties in the definition of the axial depressive syndrome and its clinical forms. This gives rise to a number of problems regarding their definition and delimitation from other mental disorders and from normality. As a result, changing and to some extent overlapping definitions of depressive disorders have been proposed over time. A definition of axial depressive syndrome is proposed based on the differentiation between disturbances of mood and affect. The two main classificatory approaches (categorical and dimensional) are examined with regard to their appropriateness in classifying depressive disorders. Although the two approaches possess pros and cons, the dimensional approach has a number of characteristics that makes it more appropriate than the categorical approach for classifying mental disorders in general and depressive disorders in particular. A multidimensional model for classifying depressive disorders is proposed. The model includes etiological, symptomatological and course/outcome components, each of which is composed of a number of dimensions that have clinical and therapeutical relevance.