Depression: The New Era of Classification

DSM-IV-TR

So, I woke up this morning with the idea that I would look up which type of depression is worse in the morning...on the internet. Everyone knows that scanning the internet (even, ahem, Wikipedia) is not the most reliable method of obtaining accurate information. Nevertheless, I thought I'd try. I am only familiar with the following categories that depression exists under, classified under the Mood Disorders section of the DSM-IV-TR:

• Dysthymic Disorder
• Major Depressive Disorder
• Bipolar Disorder and its associated Depression
• Cyclothymic Disorder

There are several "specifiers" that describe certain features associated with the above diagnoses, such as Melancholic Features, Atypical Features, Catatonic Features, and the like.

So, you'll imagine my surprise when my research turned up the following term as a type of depression that is worse in the morning: Melancholic Depression. I also noted that the terms "Psychotic Depression" and "Catatonic Depression" were getting thrown around as well. I'm confused.

Those in the psychology profession are familiar with the psychologist's "Bible" (A.K.A. the Diagnostic and Statistical Manual of Mental Disorders, or DSM). The DSM is under revision and hence has the suffix: "IV-TR" meaning it is in it's fourth edition, currently under revision. The full title of the text is DSM-IV-TR. The panel of experts and professionals currently involved in the DSM-IV-TR revision process are discussing the changes associated with what will be released as the fifth edition of the DSM and will be appropriately dubbed the DSM-V.

Why do I bring this up? Well, it's simple: if a psychological professional needs to know what diagnosis his or her client's symptoms fall under, the DSM-IV-TR is the book to consult. It has undergone several revisions and with this current process of revisions, diagnoses are being categorized differently than they were before.  I have the most recent copy of the DSM and it has no category of depression labeled "Melancholic Depression." However, the Melancholic Features Specifier does describe a depression that is worse in the morning. I can only assume that this surprise category that turned up is a result of this revision process.

On a very circuitous path, I found my answer. I also found a reason to pay more attention to the revision process of the DSM. It is, after all, the book I shall be married to in my practice. I must learn to love it.