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The Spectrum Model: A More Coherent Approach to the Complexity of Psychiatric Symptomatology

Published online by Cambridge University Press:  07 November 2014

Ellen Frank ,
Giovanni B. Cassano ,
M. Katherine Shear ,
Alessandro Rotondo ,
Liliana Dell'Osso ,
Mauro Mauri ,
Jack Maser  and
Victoria Grochocinski
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Abstract

The current tools used to define and diagnose mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, have added specificity to the psychiatric nomenclature. However, their stereotypic rigidity in classification has resulted in the failure to identify the full range of potentially debilitating psychiatric symptoms with which patients may present. A spectrum model of psychopathology is more adept at recognizing the subclinical or threshold symptomatology that may occur concomitantly with core psychiatric disorders. The authors discuss the development of a spectrum approach to the diagnosis of mental disorders, which offers the potential to improve treatment selection and therapeutic outcomes.

Type
Feature Articles
Information
CNS Spectrums , Volume 3 , Issue 4: The Panic-Agoraphobic Spectrum , April 1998 , pp. 23 - 34
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Menninger, K, Mayman, M, Pruyser, P. The Vital Balance: The Life Process in Mental Health and Illness. New York, NY: Viking Press; 1963.Google Scholar
2.Kraepelin, E. Der Psychologische Versuch in der Psychiatrie Psychologische Arbeiten. 1896;1:1–91.Google Scholar
3.Meyer, A. Psychobiology: A Science of Man. Springfield, Ill: Charles A. Thomas; 1957.Google Scholar
4.Feighner, JP, Robins, E, Guze, SB, Woodruff, RA, Winokur, G, Munoz, R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972;26:57–63.CrossRefGoogle ScholarPubMed
5.Spitzer, R, Endicott, J, Robins, E. Research diagnostic criteria. Arch Gen Psychiatry. 1978;35:773–782.CrossRefGoogle ScholarPubMed
6.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed (DSM-IV). Washington, DC: American Psychiatric Association; 1994.Google Scholar
7.World Health Organization. The International Classification of Diseases: ICD-9-CM. Geneva, Switzerland: World Health Organization; 1978.Google Scholar
8.World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva, Switzerland: World Health Organization; 1992.Google Scholar
9.Kupfer, DJ, Foster, G. Interval between onset of sleep and rapid-eye-movement sleep as an indicator of depression. Lancet. 1972;2:684–686.CrossRefGoogle ScholarPubMed
10.Benca, RM, Obermeyer, WH, Thisted, RA, Gillin, C. Sleep and psychiatric disorders: a meta-analysis. Arch Gen Psychiatry. 1992;49:651–668.CrossRefGoogle ScholarPubMed
11.McMahon, WM, van de Wetering, BJ, Filloux, F, Betit, K, Coon, H, Leppert, M. Bilineal transmission and phenotypic variation of Tourette's disorder in a large pedigree. J Am Acad Child Adolesc Psychiatry. 1996;35:672–680.CrossRefGoogle Scholar
12.Kurlan, R, Behr, J, Medved, L, Shoulson, I, et al.Familial Tourette's syndrome: report of a large pedigree and potential for linkage analysis. Neurology. 1986;36:772–776.CrossRefGoogle ScholarPubMed
13.Pauls, DL, Cohen, DJ, Heimbuch, R, Detlor, J, Kidd, KK. Familial pattern and transmission of Gilles de la Tourette syndrome and multiple tics. Arch Gen Psychiatry. 1981;38:1091–1093.CrossRefGoogle ScholarPubMed
14.Judd, LL. The clinical course of unipolar major depressive disorders (commentary). Arch Gen Psychiatry. 1997;54:989–991.CrossRefGoogle Scholar
15.Kendler, KS, Gardner, CO Jr. Boundaries of major depression: an evaluation of DSM-IV criteria. Am J Psychiatry. 1998;155:172–177.Google Scholar
16.Angst, J, Merikangas, KR, Preisig, M. Subthreshold syndromes of depression and anxiety in the community. J Clin Psychiatry. 1997;58(suppl 8):6–10.Google Scholar
17.Feske, U, Frank, E, Kupfer, DJ, Shear, MK, Weaver, E. Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: an exploratory investigation. Depression and Anxiety. In press.Google Scholar
18.Maser, JD, Weiss, R, Gwirtsman, H. Depression and its boundaries with selected Axis I disorders. In: Beckham, EE, Leber, WR, eds. Handbook of Depression. 2nd ed. New York, NY: Guilford Publications; 1995:86–106.Google Scholar
19.Sturm, R, Wells, KB. How can care for depression become more cost-effective? JAMA. 1995;273:51–58.CrossRefGoogle ScholarPubMed
20.Judd, LL, Akiskal, HS, Maser, JD, et al.A prospective 12 year study of sub-syndromal and syndromal depressive symptomatology in 431 patients with unipolar major depressive disorder. Arch Gen Psychiatry. In press.Google Scholar
21.Cassano, GB, Michelini, S, Shear, MK, Coli, E, Maser, JD, Frank, E. The panic-agoraphobic spectrum: a descriptive approach to the assessment and treatment of subtle symptoms. Am J Psychiatry. 1997;154(suppl 6):27–38.Google Scholar