DSM4 and Depression

The purpose of the decision trees in DSM4 is to aid the clinician in understanding the organization and hierarchical structure of the DSM-IV Classification. Each decision tree starts with a set of clinical features. When one of these features is a prominent part of the presenting clinical picture, the clinician can follow the series of questions to rule in or rule out various disorders. Note that the questions are only approximations of the diagnostic criteria and are not meant to replace them.

The Psychotic Disorders decision tree is the only one that contains disorders that are mutually exclusive (i.e., only one disorder from that section can be diagnosed in a given individual for a particular episode). For that orther decision trees, it is important to refer to the individual criteria sets to determine when more than one diagnosis may apply.

Many of the DSM IV criteria defining addiction refer either to physical dependency or tolerance which are physiological and expected with the long-term opioid use (criteria 1 and 2) or to other occurrences which may be normal and expected in the course of opioid therapy of chronic pain (criteria 3 and 4)Clinical Trials: Aripiprazole was evaluated as a treatment for schizophrenia in four short-term (4 to 6 weeks) placebo-controlled trials of acutely relapsed inpatients who predominantly met DSM-III/IV criteria for schizophrenia.Seventy-four patients meeting DSM-III criteria for social phobia completed 4 or more weeks of double-blind, randomized treatment with the monoamine oxidase inhibitor phenelzine, the cardioselective beta-adrenergic blocker atenolol, or placebo.