Am J Psychiatry 1990; 147:1173-1179
Copyright © 1990 by American Psychiatric Association
Variability in the application of contemporary diagnostic criteria: endogenous depression as an example
M Zimmerman, WH Coryell and DW Black
Department of Psychiatry, University of Iowa College of Medicine, Iowa City.
Specified diagnostic criteria have been credited, in part, with improving
diagnostic reliability. The authors hypothesize that nonuniform application
of these criteria across different research centers has been one factor
responsible for the failure to replicate research findings. For example,
researchers using a narrow interpretation of the Research Diagnostic
Criteria (RDC) have found a highly significant association between
endogenous depression and a positive dexamethasone suppression test result,
whereas researchers using a broad interpretation have failed to find the
predicted relationship. The authors used two interpretations of the RDC and
DSM- III endogenous/melancholia criteria to diagnose 60 depressed patients
and found significant difference in rates of diagnoses and symptoms.
