Who Discovered Major Depression?

Depression as a separate mental state has been recognized and commented on almost since the beginning of recorded time. What we know today as major depression really came about as more of definition refinement rather than a discovery of the psychological state itself.

History

• As far back as ancient Greece, human beings have been trying to understand depression. In his work Aphorisms, the physician Hippocrates offered the following characteristics of melancholia: "fears and despondencies, if they last a long time."

  For centuries, depression was more popularly referred to as melancholia, which means "black bile" in ancient Greek. Early 20th century German psychiatrist Emil Kraepelin referred to the various kinds of melancholia as depressive states, introducing a new way to describe the illness. The word depression comes from the Latin verb deprimere, which means to press down (as in a person's spirits).

DSM

• The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an encyclopedia of criteria for diagnosing mental disorders. Published by the American Psychiatric Association, it is widely used by members of the mental health community.

  First published in 1952 and revised five times, the DSM's first two editions (DSM-I and DSM-II) did not include major depressive disorder (MDD), although they included other depressive conditions.

DSM Deficits

• According to Robert Spritzer, who chaired DSM-II's revision, the previous versions of DSM " ... only contained general and often vague descriptions of the clinical features of the various mental disorders." (CE: See Reference #2 Current Contents, May 8, 1989)

  Spritzer and his colleagues corrected the lack of specificity and uniformity in classifying mental disorders by developing the Research and Diagnostic Criteria. This classification system was the basis for the widespread revisions found in DSM-III, including the introduction and diagnostic criteria for MDD.

MDD Defined

• In their 2005 paper "Classification of Depression: Research and Diagnostic Criteria: DSM-IV and ICD-10," Alan M. Gruenberg, Reed D. Goldstein and Harold Alan Pincus explain that DSM-III contained specific criteria to define a major depressive episode, including , "... the adoption of a primary distinction between major depressive disorders and bipolar disorders. Depressive reaction and neurotic depression, included in previous editions of DSM, were removed.

MDD Today

• The most current edition of DSM (DSM-IV) lists five criteria for diagnosing MDD. The first criterion states the patient must have a minimum of five symptoms out of a list of nine during a two-week period. These include feeling sad or empty most hours of the day, loss of interest in all or nearly all activities, not sleeping enough or sleeping too much most days and trouble thinking or making decisions.

MDD Evolves

• The definition of MDD continues to come under examination as members of the clinical and academic communities work with current DSM depression criteria. For instance, Gruenberg, Goldstein and Pincus report that classification criteria for depressive disorders may need to change as more is understood about a possible genetic component to depression.