Also, mood disorders range widely from mild to severe, said Dr. Jan Fawcett, chairman of the mood disorders work group, one of 13 committees on the task force. A person with four of the nine listed symptoms for depressive disorder can be more troubled and disabled than another person with six of the nine symptoms.
"We don't want to take everyone who is demoralized by life and call it depression," he said. "But we also don't want to miss something."
Attention to finer shades will also help doctors and therapists recognize disorders in their earliest stages, when they are mild and easier to treat or prevent. Psychiatrists are especially interested in identifying prodromal forms, or earliest symptoms, of conditions such as bipolar disorder, schizophrenia and dementia, said Dr. William Carpenter Jr., psychiatry professor at the University of Maryland and chairman of the psychotic disorders work group.
Other changes simply reflect modern times, with obesity, for example, potentially to be labeled as a symptom of, or risk factor for, a mental disorder. This, among other things, may help doctors address a growing controversy on whether candidates for bariatric surgery are being adequately screened for their psychological health before they undergo the procedure.