Hostname: page-component-89b8bd64d-r6c6k Total loading time: 0 Render date: 2026-05-13T08:38:25.688Z Has data issue: false hasContentIssue false
  • English
  • Français

High heterogeneity and low reliability in the diagnosis of major depression will impair the development of new drugs

Published online by Cambridge University Press:  02 January 2018

Samuel M. Lieblich ,
David J. Castle ,
Christos Pantelis ,
Malcolm Hopwood ,
Allan Hunter Young  and
Ian P. Everall
Samuel M. Lieblich*
Affiliation:
Department of Psychiatry, University of Melbourne, Melbourne, Australia
David J. Castle
Affiliation:
St Vincent's Hospital Melbourne and The University of Melbourne and Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
Christos Pantelis
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health and Florey Institute for Neuroscience & Mental Health, Melbourne, Australia, and Bedfordshire Centre For Mental Health Research in Association with the University of Cambridge, UK
Malcolm Hopwood
Affiliation:
Professorial Psychiatry Unit, Albert Road Clinic, and University of Melbourne, Melbourne, Australia
Allan Hunter Young
Affiliation:
Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Ian P. Everall
Affiliation:
Department of Psychiatry, University of Melbourne, Melbourne, Australia
*
Samuel M. Lieblich, Department of Psychiatry, University of Melbourne, Level: 01 Room: N10023, Main Block, Royal Melbourne Hospital, Parkville, Victoria 3052, Australia. Email: samuel.lieblich@unimelb.edu.au
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

Major depressive disorder is a common diagnosis associated with a high burden of disease that has proven to be highly heterogeneous and unreliable. Treatments currently available demonstrate limited efficacy and effectiveness. New drug development is urgently required but is likely to be hindered by diagnostic limitations.

Information

Type
Editorial
Information
BJPsych Open , Volume 1 , Issue 2 , October 2015 , pp. e5 - e7
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2015

Footnotes

Declarations of interest

D.J.C. has received grants and personal fees from Eli Lilly, Janssen-Cilag, Roche, Allergen, Bristol-Myers Squibb, Pfizer, Lundbeck, AstraZeneca, Hospira, Organon, Sanofi-Aventis, and Wyeth during the writing of this review. C.P. has received grant support from Janssen-Cilag, Eli Lilly, Hospira (Mayne), AstraZeneca, and received honoraria for consultancy to Janssen-Cilag, Eli Lilly, Hospira (Mayne), AstraZeneca, Pfizer, Schering Plough, and Lundbeck. Over the past 2 years he has participated on advisory boards for Janssen-Cilag and Lundbeck, and received honoraria for talks presented at educational meetings organised by AstraZeneca, Janssen-Cilag and Lundbeck. M.H. has received personal fees or grants from Lundbeck, AstraZeneca and Servier during the writing of this review. A.H.Y. reports personal fees from Lundbeck, Sunovion, AstraZeneca and Janssen outside the submitted work. I.P.E. has received personal fees or grants from Lundbeck, AstraZeneca, and Abbvie during the writing of this review.

References

1 Murray, CJ, Vos, T, Lozano, R, Naghavi, M, Flaxman, AD, Michaud, C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2197–223.CrossRefGoogle ScholarPubMed
2 Regier, DA, Narrow, WE, Clarke, DE, Kraemer, HC, Kuramoto, SJ, Kuhl, EA, et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry 2013; 170:59–70.CrossRefGoogle ScholarPubMed
3 McHugh, M. Interrater reliability: the kappa statistic. Biochem Med 2012; 22: 276–82.Google ScholarPubMed
4 Kessler, RC, Berglund, P, Demler, O, Jin, R, Koretz, D, Merikangas, KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003; 289: 3095–105.CrossRefGoogle ScholarPubMed
5 Pigott, HE, Leventhal, AM, Alter, GS, Boren, JJ. Efficacy and effectiveness of antidepressants: current status of research. Psychother Psychosom 2010; 79: 267–79.CrossRefGoogle ScholarPubMed
6 Spitzer, RL, Fleiss, JL. A re-analysis of the reliability of psychiatric diagnosis. Br J Psychiatry 1974; 125: 341–7.CrossRefGoogle ScholarPubMed
7 Williams, JBW, Gibbon, M, First, MB, Spitzer, RL, Davies, M, Borus, J, et al. The structured clinical interview for DSM-III-R (SCID) reliability description of sites. Arch Gen Psychiatry 1992; 49: 630–6.CrossRefGoogle Scholar
8 Brown, TA, Di Nardo, PA, Lehman, CL, Campbell, LA. Reliability of DSM-IV anxiety and mood disorders: implications for the classification of emotional disorders. J Abnorm Psychol 2001; 110:49–58.CrossRefGoogle ScholarPubMed
9 Spitzer, RL, Forman, JB, Nee, J. DSM-III field trials: I. Initial interrater diagnostic reliability. Am J Psychiatry 1979; 136: 815–7.Google ScholarPubMed
10 Kirsch, I, Deacon, BJ, Huedo-Medina, TB, Scoboria, A, Moore, TJ, Johnson, BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5: e45.CrossRefGoogle ScholarPubMed
11 Carroll, BJ. Bringing back melancholia. Bipolar Disord 2012; 14: 1–5.CrossRefGoogle ScholarPubMed
12 Corruble, E, Falissard, B, Gorwood, P. Is DSM-IV bereavement exclusion for major depression relevant to treatment response? A case-control, prospective study. J Clin Psychiatry 2011; 72: 898–902.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.