Depression and Expressive Behavior

Depression and Expressive Behavior

Depression and Expressive Behavior

Depression and Expressive Behavior


The clinical interview is an indispensable first step in a comprehensive general medical evaluation. In psychiatry and clinical psychology, it is too frequently the only step in the evaluation.

Based on papers presented at an National Institute of Mental Health sponsored workshop, this volume specifically addresses the question of whether the clinical phenomenology necessary for diagnosis of mental disorders can be assessed in ways more objective and accurate than routine clinical observation.


Reliance solely on the clinical interview to assess psychiatric problems sharply contrasts with other medical fields. Neurologists routinely employ electromyography to measure the extent and nature of muscular dysfunction. Cardiologists use cardiac catheterization to confirm abnormalities in heart valve functioning. Internists call for upper gastrointestinal series to follow up an impression of peptic ulcer disease. the clinical interview is an indispensible first step in a comprehensive general medical evaluation; in psychiatry and clinical psychology it is too frequently the only step in the evaluation. This situation has been changing and will continue to do so in the foreseeable future.

Advances in our understanding and treatment of mental disorders have forced these changes over the past three decades. the efficacious treatments that have been developed have paralleled discoveries of alterations in neuroendocrine, psychophysiologic, and other functioning. These treatments and biological dysfunctions have not been generic to all psychiatric disorders, but rather, have been associated with particular mental disorders. Therefore, differentiation of mental disorders has become critical both for clinical and scientific reasons.

These reasons have strengthened a need for more comprehensive, reliable, and accurate methods of diagnostic assessment. in response, the National Institute of Mental Health has supported research and development of diagnostic criteria and assessment tools. the Research Diagnostic Criteria (RDC), the most widely used research tool for diagnosis, has resulted from this support. Moreover, development of The Diagnostic and Statistical Manual (DSM-III), the standard for clinical practice, by the American Psychiatric Association, followed several years later. Explicit inclusion and exclusion criteria using operationalized definitions for clinical variables are the foundations of these major diagnostic systems.

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