Psychiatrists’ and Nonpsychiatrist Physicians’ Reported Use of the <i>DSM-IV</i> Criteria for Major Depressive Disorder

Objective: Several studies of nonpsychiatrist physicians suggest that there are deficits in the knowledge and application of the diagnostic criteria for major depressive disorder (MDD). This research raises questions about the clinical utility of the MDD criteria. The goal of the present study was to determine psychiatrists’ reported use of the DSM-IV criteria for MDD to diagnose depression and to compare their use to the use by nonpsychiatrist physicians.

Method: The subjects were 291 psychiatrists and 40 nonpsychiatrist physicians who attended a continuing medical education conference in 2006 or 2007 on the treatment and management of depression. Prior to a lecture, the subjects completed a questionnaire that included a question regarding how frequently the DSM-IV diagnostic criteria for MDD are used when diagnosing depression.

Results: Nearly one-quarter of the psychiatrists indicated that they usually did not use the DSM-IV MDD criteria when diagnosing depression, and nearly half of the nonpsychiatrist physicians indicated that they rarely used the DSM-IV MDD criteria to diagnose depression.

Conclusions: A substantial minority of psychiatrists and the majority of nonpsychiatrist physicians reported that they often do not use the DSM-IV MDD criteria when diagnosing depression. These findings raise questions about the clinical utility of the MDD criteria. These results, along with other studies demonstrating problems with recalling the MDD criteria, suggest that clinical utility should be considered in discussions of revising these criteria for DSM-V.

Submitted: December 12, 2008; accepted January 16, 2009.

Online ahead of print: January 26, 2010.

Corresponding author: Mark Zimmerman, MD, Bayside Medical Center, 235 Plain Street, Providence, RI 02905 (

J Clin Psychiatry 2010;71(3):235-238