Heterogeneity of DSM-IV Major Depressive Disorder as a Consequence of Subthreshold Bipolarity

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Abstract
The diagnostic concept of major depressive disorder (MDD) was adopted in the DSM-III1 in 1980 and subsequently refined in the DSM-III-R2 and the DSM-IV.3 Since then, MDD has been described as the most frequent mood disorder, with rates up to 16%, and as highly comorbid with anxiety and substance use disorders (SUDs).4-6 In contrast as shown by large community studies, the prevalence of bipolar disorders (BPDs) is 2%, considerably lower.7-10

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