The DSM-IV (depression) classification: to be or not to be?

In 1958, when I started my residency training in psychiatry, diagnostic confusion reigned in the realm of depressive disorders. Diagnostic concepts were not operationalized, nomenclature was not standardized, and no taxonomy was generally accepted. What is the situation today, some 30 years later? Today we work under the patronage of the DSM-III classification of depression, a system in which diagnostic concepts are operationalized, nomenclature is standardized, and this nomenclature is officially accepted in the United States and de facto accepted in numerous countries all over the world. Did that system provide order where chaos reigned? The answer has to be in the negative.