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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2006 December;47(4):275-84

language: English

Depressed or on the edge? Boundaries of depressive illness

Hafizi S.

Department of Psychiatry Warneford Hospital Headington, Oxford, UK


Depressed mood is a common symptom in the general population and is usually a normal and transient reaction to life stress and difficulty. On the other hand, depressive illness is a syndrome of psychopathological symptoms and signs with significant effects on an individual’s functioning. Our current classifications essentially use a categorical approach to define depressive illness. This contrasts with a dimensional approach that sees depression on a continuum and acknowledges the presence of symptoms on the edges of a categorically defined depressive syndrome. There are a number of psychological phenomena at the boundaries of major depressive disorder that are interesting areas of dispute. Some of these include depressive personality, adjustment disorders, recurrent brief depression, bereavement and complicated grief, postnatal mood states, mixed anxiety-depressive disorder and schizo-affective disorder. In addition, temperament may also play a role as an underlying factor in both personality and psychopathology. In fact, a number of investigators have confirmed that high neuroticism scores can predispose individuals to depression. Furthermore, all of these psychological phenomena must also be considered within the wider socio-cultural context. The categorical versus dimensional argument is likely to continue, but this debate is necessary if our current understanding of mental disorders is to improve.

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