Introducing the concept of modern depression in Japan; An international case vignette survey

Takahiro A. Kato, Naotaka Shinfuku, Daisuke Fujisawa, Masaru Tateno, Tetsuya Ishida, Tsuyoshi Akiyama, Norman Sartorius, Alan R. Teo, Tae Young Choi, Anne P.F. Wand, Yatan Pal Singh Balhara, Jane Pei Chen Chang, Rita Yuan Feng Chang, Behrang Shadloo, Helal Uddin Ahmed, Tiraya Lerthattasilp, Wakako Umene-Nakano, Hideki Horikawa, Ryohei Matsumoto, Hironori KugaMasuo Tanaka, Shigenobu Kanba

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)


Aim: Japanese psychiatrists have increasingly reported patients with depression that does not seem to fit the criteria of the ICD-10 and the DSM-IV, and which has recently been called modern type depression (MTD). We explored whether MTD is frequently seen in Japan and also in other countries, and if so, how patients with MTD are diagnosed and treated. Methods: The questionnaires, with two case vignettes (traditional type depression (TTD) and MTD), were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated their opinions about each case's prevalence in their country, etiology, diagnosis, suicide risk, and treatment using Likert scales. Results: Out of 247 responses (123 from Japan and 124 from other countries), two hundred thirty-nine valid responses were received. MTD was recognized in all participating countries, and especially in urban areas. Generally, the factor of personality was regarded as the most probable cause of MTD. Whereas about 90% of Japanese psychiatrists applied the ICD/DSM criteria to TTD, only about 60% applied the criteria to MTD. Conclusion: Our results indicate that Japan's MTD seems to be occurring in many other countries, and that the present ICD/DSM criteria may not be sufficient to diagnose MTD. Therefore, it could be an important candidate for a new international diagnostic criterion as a subtype of depression. A clear diagnostic framework and consensus on the interventions to treat MTD would be valuable. Further clinical, psychopathological and international epidemiological studies are needed to confirm our preliminary findings of MTD.

Original languageEnglish
Pages (from-to)66-76
Number of pages11
JournalJournal of Affective Disorders
Issue number1-3
Publication statusPublished - Dec 2011

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health


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