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To the Editor.—
Several recent issues of the Archives have contained articles reporting high prevalences of DSM-III major depressive episodes (MDEs) in one or another population. There is, I think, a misunderstanding regarding the importance of this diagnosis that may affect future research adversely.In developing criteria for the diagnosis of MDE, the framers of the DSM-III were not trying to limit excessive diagnosis, as was the case with schizophrenia. They included as criteria symptoms that persons with clinically diagnosed depression often manifest.Unfortunately, however, there are few severity requirements for the DSM-III diagnostic criteria of MDE. Poor appetite "nearly every day for a period of at least two weeks," for example, is sufficient, though the poor appetite may range from mild, without weight loss, to very severe. Similarly, there are no severity criteria for insomnia, loss of energy, difficulty concentrating, etc. Thus, a large number of very mild depressives
Mattes J. DSM-III Criteria for Major Depressive Episode. Arch Gen Psychiatry. 1981;38(9):1068. doi:10.1001/archpsyc.1981.01780340120017