{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:50:16Z","timestamp":1788317416812,"version":"build-2803163510"},"reference-count":60,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2015,6,17]],"date-time":"2015-06-17T00:00:00Z","timestamp":1434499200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:p>Two different and seemingly competing views on the diagnosis of major depressive disorder (MDD) exist. The first is that the diagnosis conflates adaptive sadness reactions with pathological states of depressed mood and that MDD is overdiagnosed and overtreated. The second is that MDD is an underdiagnosed and undertreated disorder, and one that is best characterised by a severe, chronic, recurrent or treatment-resistant course. Existing research suggests that both views are valid and merit being integrated. Anywhere from 30 to 50% of individuals will meet criteria for MDD at some point in their life. About half of these episodes are of brief duration and unlikely to recur. However, a remaining half is either chronic or recurrent. Data on the outpatient diagnosis of depression support the view that depression is simultaneously underdiagnosed and undertreated as well as overdiagnosed and overtreated. About one-third of the patients who meet criteria for MDD and receive placebos experience clinically significant and long-lasting improvement. Many other patients, however, are unresponsive to one or multiple active treatments. Thus, the diagnosis of MDD likely applies to individuals who are experiencing either normal periods of sadness or single-episode afflictions that are mild, unlikely to recur, and are placebo responsive, as well as to individuals with more severe clinical profiles. More research is needed that can help ascertain what contextual or biopsychological variables help distinguish between individuals who may be experiencing adaptive states of negative affect and those who experience severe, chronic, recurrent or treatment-resistant depressions.<\/jats:p>","DOI":"10.1017\/s2045796015000542","type":"journal-article","created":{"date-parts":[[2015,6,17]],"date-time":"2015-06-17T05:37:36Z","timestamp":1434519456000},"page":"466-472","source":"Crossref","is-referenced-by-count":49,"title":["Heterogeneity in the prognosis of major depression: from the common cold to a highly debilitating and recurrent illness"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8882-0243","authenticated-orcid":false,"given":"L.","family":"Lorenzo-Luaces","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,6,17]]},"reference":[{"key":"S2045796015000542_ref53","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20015"},{"key":"S2045796015000542_ref36","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05776blu"},{"key":"S2045796015000542_ref34","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1176\/ajp.156.7.1000","article-title":"Recurrence after recovery from major depressive disorder during 15 years of observational follow-up","volume":"156","author":"Mueller","year":"1999","journal-title":"American Journal of Psychiatry"},{"key":"S2045796015000542_ref14","volume-title":"Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life","author":"Frances","year":"2014"},{"key":"S2045796015000542_ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.10.017"},{"key":"S2045796015000542_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.01.029"},{"key":"S2045796015000542_ref5","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.109.076448"},{"key":"S2045796015000542_ref18","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195313048.001.0001","volume-title":"The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder","author":"Horwitz","year":"2007"},{"key":"S2045796015000542_ref38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.00959.x"},{"key":"S2045796015000542_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"S2045796015000542_ref21","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.9.1501"},{"key":"S2045796015000542_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830230023003"},{"key":"S2045796015000542_ref54","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12184"},{"key":"S2045796015000542_ref23","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-200202000-00007"},{"key":"S2045796015000542_ref15","volume-title":"The Book of Woe: The DSM and the Unmaking of Psychiatry","author":"Greenberg","year":"2013"},{"key":"S2045796015000542_ref3","article-title":"The epidemiology of common mental disorders from age 20 to 50: results from the prospective Zurich cohort study","author":"Angst","year":"2015","journal-title":"Epidemiology and Psychiatric Sciences"},{"key":"S2045796015000542_ref37","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39268.475799.AD"},{"key":"S2045796015000542_ref2","doi-asserted-by":"publisher","DOI":"10.1037\/a0016242"},{"key":"S2045796015000542_ref32","doi-asserted-by":"publisher","DOI":"10.1037\/a0025190"},{"key":"S2045796015000542_ref40","doi-asserted-by":"publisher","DOI":"10.1177\/070674371005501006"},{"key":"S2045796015000542_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.02.026"},{"key":"S2045796015000542_ref50","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.10.1552"},{"key":"S2045796015000542_ref47","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780199948086.001.0001","volume-title":"How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown","author":"Shorter","year":"2013"},{"key":"S2045796015000542_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.11.021"},{"key":"S2045796015000542_ref38a","doi-asserted-by":"publisher","DOI":"10.1080\/00048670802345458"},{"key":"S2045796015000542_ref11","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.3.217"},{"key":"S2045796015000542_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710000772"},{"key":"S2045796015000542_ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050045"},{"key":"S2045796015000542_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.01.027"},{"key":"S2045796015000542_ref41","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.2.109"},{"key":"S2045796015000542_ref31","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2010.1024"},{"key":"S2045796015000542_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709991036"},{"key":"S2045796015000542_ref51","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4088\/JCP.13m08824","article-title":"Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study","volume":"76","author":"Takayanagi","year":"2014","journal-title":"The Journal of Clinical Psychiatry"},{"key":"S2045796015000542_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707000074"},{"key":"S2045796015000542_ref6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004824"},{"key":"S2045796015000542_ref58","first-page":"344","article-title":"Reasons for preferring a primary care physician for care if depressed","volume":"43","author":"Wun","year":"2011","journal-title":"Family Medicine"},{"key":"S2045796015000542_ref1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"S2045796015000542_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.5.468"},{"key":"S2045796015000542_ref44","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000227690.95757.64"},{"key":"S2045796015000542_ref30a","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0704"},{"key":"S2045796015000542_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1054"},{"key":"S2045796015000542_ref33","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711002066"},{"key":"S2045796015000542_ref48","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.3.208"},{"key":"S2045796015000542_ref45","volume-title":"Helplessness: On Depression, Development, and Death","volume":"1","author":"Seligman","year":"1975"},{"key":"S2045796015000542_ref55","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.4.433"},{"key":"S2045796015000542_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.23.3095"},{"key":"S2045796015000542_ref12","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.65.5.513"},{"key":"S2045796015000542_ref43","doi-asserted-by":"publisher","DOI":"10.1177\/2167702612457599"},{"key":"S2045796015000542_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39268.497350.AD"},{"key":"S2045796015000542_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2004.00475.x"},{"key":"S2045796015000542_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60879-5"},{"key":"S2045796015000542_ref57","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.105.009522"},{"key":"S2045796015000542_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2007.10.004"},{"key":"S2045796015000542_ref52","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.3579"},{"key":"S2045796015000542_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(81)90023-9"},{"key":"S2045796015000542_ref20","first-page":"203","article-title":"Depression's vicious scree: self-propagating and erosive processes in depression chronicity","volume":"7","author":"Joiner","year":"2000","journal-title":"Clinical Psychology: Science and Practice"},{"key":"S2045796015000542_ref9","doi-asserted-by":"publisher","DOI":"10.1037\/a0020570"},{"key":"S2045796015000542_ref56","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.14.1840"},{"key":"S2045796015000542_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1943"},{"key":"S2045796015000542_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200009000-00006"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796015000542","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T15:08:06Z","timestamp":1717945686000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796015000542\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,17]]},"references-count":60,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["S2045796015000542"],"URL":"https:\/\/doi.org\/10.1017\/s2045796015000542","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,17]]}}}