As one of the investigators who has reported on epidemiologic rates of major depression, I welcome Dr Mattes' letter regarding the high prevalence of DSM-III MDEs reported in recently published articles in the Archives. The chief criticism by Dr Mattes is that the DSM-III diagnostic criteria for major depression do not include sufficient severity requirements. Therefore, a large num ber of mild depressives, who otherwise might never be considered for treatment, could meet these criteria. He suggests that the diagnosis of depressive neurosis in the DSM-II might better describe the condition of these patients.
Several points require clarification. To my knowledge, the published epidemiologic studies, including my own,1 have not used the DSM-III criteria because these criteria have not been available until recently. These studies have used the RDC criteria for major depression. The RDC require persistence of symptoms for two weeks and severity to the point of causing