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Depressive Symptoms and Depressive Diagnoses in a Community Population:  Use of a New Procedure for Analysis of Psychiatric Classification

Dan Blazer, MD, PhD; Marvin Swartz, MD; Max Woodbury, PhD, MPH; Kenneth G. Manton, PhD; Dana Hughes, PhD; Linda K. George, PhD
Arch Gen Psychiatry. 1988;45(12):1078-1084. doi:10.1001/archpsyc.1988.01800360026004.
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• A multivariate classification technique was used to examine whether depressive symptoms and symptoms frequently associated with depressive disorders would cluster into recognizable syndromes that parallel traditional DSM-III psychiatric diagnoses. An analysis was made of all respondents in the Epidemiologic Catchment Area (ECA) project of the Piedmont region of North Carolina who reported suffering from depressive symptoms (n = 406) at the second wave of the ECA study. The analysis identified five profiles of symptoms that adequately described the interrelationships of the symptoms as reported in the population. One profile included a set of symptoms nearly identical to the symptoms associated with the DSM-III classification of major depression. Other depressive syndromes emerged and included a premenstrual syndrome among younger women and a mixed anxiety/depression syndrome. The existence of these other depressive syndromes may explain the present discrepancy in the epidemiologic literature between a high prevalence of depressive symptoms and a low prevalence of traditional depressive diagnoses in community populations.

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