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December 1985

Treatment Outcome Validation of DSM-III Depressive SubtypesClinical Usefulness in Outpatients With Mild to Moderate Depression

Author Affiliations

From the Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York.

Arch Gen Psychiatry. 1985;42(12):1148-1153. doi:10.1001/archpsyc.1985.01790350022005

• An algorithm for transcribing Research Diagnostic Criteria diagnoses for depressive disorders to similar categories in the DSM-III was applied to 103 depressed outpatients previously diagnosed by Research Diagnostic Criteria. All had Hamilton Depression Rating Scale scores of 18 or less. Among 64 patients completing a six-week, double-blind study comparing desipramine hydrochloride with placebo, desipramine was significantly more effective than placebo in patients with DSM-III major depression but not in those with dysthymic disorder. Among patients with major depression, a significant drug-placebo response difference was demonstrated even in those without melancholia. These findings support the clinical usefulness of the DSM-III in the treatment of depressed outpatients. Independent of DSM-III diagnosis, however, evidence of panic attacks seemed to identify patients who benefited from desipramine therapy. This suggests that the DSM-III hierarchy, which excludes consideration of panic in patients with major depression, may require revision.