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In reply

Regier et al are correct in saying that diagnostic concepts in psychiatry require further evaluation and that one important aspect of this enterprise is to distinguish "homogenous diagnostic groups with greater predictive validity with respect to both prevention and treatment response." We took a step in this direction in our article by examining the predictive validity of milder forms of mental disorders in a 10-year prospective follow-up study of respondents who participated in the National Comorbidity Survey.¹ Specifically, we found that a substantial proportion of individuals with mild mental disorders in 1990 subsequently went on to have mental disability, suicide attempts, or hospitalization for mental illness in 2000. Narrow et al ² propose to exclude these mild cases from the DSM system. Our results suggest that failure to classify mild cases would be a mistake.

In their letter, Regier et al support the exclusion of mild cases from the . . . [Full Text of this Article]

AUTHOR INFORMATION
Ronald C. Kessler, PhD; Kathleen R. Merikangas, PhD; Patricia Berglund, MBA; William W. Eaton, PhD; Doreen S. Koretz, PhD; Ellen E. Walters, MS

RELATED ARTICLE

For DSM-V, It’s the "Disorder Threshold," Stupid
Darrel A. Regier, William E. Narrow, and Donald S. Rae
Arch Gen Psychiatry. 2004;61(10):1051.
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