Clinical Depression Versus Distress Among Patients With Type 2 Diabetes: Not Just a Question of Semantics
Response to Vale
- Lawrence Fisher, PHD1,
- Marilyn M. Skaff, PHD1,
- Joseph T. Mullan, PHD2,
- Patricia Arean, PHD3,
- David Mohr, PHD3,
- Umesh Masharani, MD4,
- Russell Glasgow, PHD5 and
- Grace Laurencin, MD1
- 1Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
- 2Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California
- 3Department of Psychiatry, University of California, San Francisco, San Francisco, California
- 4Department of Medicine, University of California, San Francisco, San Francisco, California
- 5Kaiser Permanente of Colorado, Denver, Colorado
- Address correspondence to Lawrence Fisher, PhD, Department of Family and Community Medicine, Box 0900, UCSF, San Francisco, CA 94143. E-mail: fisherl{at}fcm.ucsf.edu
Dr. Vale (1) suggests that the current definition of major depressive disorder is too heterogeneous and that there are many distinct depressive subtypes that manifest differently but that share a similar physiological profile. He argues that biological markers should be included in studies of disease-related psychosocial stress. We agree in principle that there are a variety of syndromes that include negative affect as a major component and that clinical depression presents in a variety of forms. We raise two issues with respect to Dr. Vale's thoughtful comments.
First, although we reported in our study that the prevalence of clinical depression, defined …
