Moving from categories to dimensions in the phenomenology of depression and anxiety

Research into the relation between psychopathology and etiological factors (e.g. endophenotype, genotype, trauma's, personality) has not yet resulted in clear findings. One of the probable causes is that most researchers use the categorical DSM IV Classification of mental disorders. We used a dimensional approach to assess distinct aspects of psychopathology, which has several advantages compared to categorical systems: comorbidity, lack of diagnostic agreement and arbitrary nature of used boundaries are no longer a problem. In the present study we develop a model with orthogonal (not correlated) dimensions that adequately describes mood- and anxiety disorders. This model can be used in etiological research (e.g. endophenotype, genotype, personality).

This project used data collected through Routine Outcome Monitoring (ROM). All patients referred for a mood-, anxiety- or somatoform disorder to the GGZ Rivierduinen outpatient clinics or LUMC department of psychiatry were assessed by a psychiatric research nurse at the start of treatment. A standardized diagnostic interview, rating scales, and self-report rating instruments were administered. Analyses were performed on comorbidity in a naturalistic patient sample (n=3798).

Margien E. den Hollander-Gijsman