How did everyone get diagnosed with major depressive disorder?

Allan V. Horwitz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Psychiatric diagnoses often reflect a matrix of sociological factors associated with professional prestige, economic forces, and cultural fashions. Diagnostic systems conceptualize the same underlying psychosocial problems in very different ways during various time periods. Since the publication of the third edition of the Diagnostic and Statistical Manual (DSM-III) in 1980, psychological distress resulting from social circumstances that previously was viewed as a general problem of nerves, neuroses, and anxiety was transformed into the specific diagnosis of major depressive disorder. Several factors, including the contrasting ways in which DSM-III defined anxiety and depression, the necessity of using explicit diagnoses to obtain professional legitimacy and reimbursement for services, and the marketing practices of the pharmaceutical industry, account for why depression replaced anxiety as the diagnosis most suitable for treated mental health conditions. Beneath the changing veneer of psychiatric labels, however, lies the same mélange of psychic ills that resist the precise labels current diagnostic fashions strive to impose upon them.

Original languageEnglish (US)
Pages (from-to)105-119
Number of pages15
JournalPerspectives in Biology and Medicine
Issue number1
StatePublished - Dec 1 2015

All Science Journal Classification (ASJC) codes

  • Issues, ethics and legal aspects
  • Health Policy
  • History and Philosophy of Science


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