Symmetrical treatment of “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition”, for major depressive disorders

Table 9 Illustration highlighting incongruent scores on Criterion A

Symptom number	1	2	3	4	5	6	7	8	9		Episode
row 1	0	0	1	1	0	1	1	1	0	(mod 2)	0
row 2	1	0	0	1	0	0	1	1	0	(mod 2)	1
row 3	1	1	0	0	1	0	1	1	1	(mod 2)	1
row 4	1	1	0	1	1	0	1	0	1	(mod 2)	1
row 5	1	0	1	0	1	0	1	0	0	(mod 2)	1
row 6	0	0	1	1	0	1	1	0	0	(mod 2)	0
row 7	0	0	0	0	0	0	0	0	0	(mod 2)	0
row 8	1	0	0	1	0	0	1	1	0	(mod 2)	1
row 9	1	0	1	0	1	0	1	0	0	(mod 2)	1
row 10	0	0	0	0	0	0	0	0	0	(mod 2)	0
Total sum (except for row 4)	5	1	4	4	3	2	7	4	1		5
Average (except for row 4)	0.5	0.1	0.4	0.4	0.3	0.2	0.7	0.4	0.1		0.5

By specifying/focusing on an arbitral j-th row (j = 1, 2, 3,…), and by adding the components of the j-th row to all other rows individually, the components for which scores (meaning presence/absence of symptoms, effectiveness/ineffectiveness of symptoms and so on) are different from those of the j-th row can be highlighted by values of 1 (and the components equivalent to those of the j-th row can be denoted 0) according to modulo-2 arithmetic (especially, addition). If a total of 10 diagnoses are made by 10 psychiatrists for the same patient in the same session, the count of values of 1 indicates the degree of fluctuation of standardization of the j-th assessment (j-th psychiatrist). Row (patient/session) 4 in Table 1 is taken as an example (highlighted in silver). Apart from the extreme right column, 31 (count of the value 1) divided by 81 cells (= ‘10 – 1’ (rows) × 9 (items)) (that for the other nine psychiatrists; except for 4-th row) = 31/81 = 0.3827 = 38.27 (%) could be regarded as a ratio for unstandardization of the j-th assessment (psychiatrist). In the extreme right column, a value of 0 (or 1) means the equivalency (non-equivalency) of the respective diagnosis for an episode to the highlighted case (in this case, row 4); this also obeys modulo-2 addition

ISSN: 1751-0473