What two-thirds of practicing psychiatrist wanted the diagnostic

 

What can be seen as one of the most important changes regarding Major
depressive disorder within the DSM-5 is the removal of the exclusion of bereavement. This illustrates how bereavement
is now considered as a factor which can lead to or be classified as major depressive
disorder without being seen as an independent problem outside of itself. The
DSM-5 has tried to make a bigger effort to distinguish the symptoms of
bereavement and major depressive episodes in order to allow the variability in
the diagnosis of major depressive disorder to be more accurate (Koukopoulos, Sani, & Ghaemi (2013). This criteria to help identify
when emotional, psychological and physical behaviours of a patient following
the loss of a loved one give guidance to clinicians to be able to differentiate
between when behaviours are caused due to major depressive disorder. However,
the DSM-5 still relies on clinicians to be able to make the distinction between
the two, which places emphasis of clinical judgment in it. Inevitably this
increased element within the DSM-5 has been praised and criticized because of
the consequent results that it yields in the diagnosis of major depressive
disorder. Due to the DSM-5 relying on clinical judgement a higher burden of
responsibility is placed on clinicians for them to be able to identify between
a depressive episode or what is a normal response (Maj, 2013). It has been shown that from the
viewpoint if clinicians that this is a positive change as two-thirds of
practicing psychiatrist wanted the diagnostic manual to be more flexible
allowing their knowledge and judgement instead of a fixed diagnostic criteria (Reed,
Correia, Esparza, Saxena & Maj, 2011).

 

Within
the DSM-5, Major Depressive Disorder (also known as clinical or unipolar
depression) is classified as disorder which requires people to have five or
more depressive symptoms (major depressive episode) from a set of nine; significant
weight loss/weight gain or changes in appetite; insomnia or hypersomnia; unable
to sit still or lethargy; loss of energy or fatigue; feelings of worthlessness
or excessive, inappropriate guilt; impaired concentration/slowed down
thinking/indecisiveness and recurring thoughts of death/suicide. Symptoms have
to last for two weeks with at least one of two symptoms being depressed mood or a loss of interest/pleasure in normally enjoyable
activities. These depressive symptoms have to cause significant distress and/or
impairment in social or occupational functioning in order to be considered
clinically problematic (Davey, 2014). 

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The
DSM-5 is the 5th edition of the diagnostic and statistical manual
for mental disorders which is predominately used in the United States of
America and the United Kingdom.  The
objective of the DSM-5 is to allow clinicians to be able to diagnose and
classify mental disorders through the use of three components in the manual; a
diagnostic classification; a diagnostic criteria set and a descriptive text of
each disorder. Due to these three components clinicians have the opportunity for
the diagnosis of a disorder to be standardised, decreasing the leeway for
subjectivity within a clinician’s diagnosis. However, ultimately a majority of
a clinician’s diagnosis will be based on their subjective view of how they have
understood the emotional, physical and psychological wellbeing of a patient.

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