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

Jonathan W. Stewart, MD; Patrick J. McGrath, MD; Michael R. Liebowitz, MD; Wilma Harrison, MD; Frederic Quitkin, MD; Judith G. Rabkin, PhD
Arch Gen Psychiatry. 1985;42(12):1148-1153. doi:10.1001/archpsyc.1985.01790350022005.
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• 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.

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