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Whether to perceive depression as a unit of symptom severity or as a subgroup with multiple heterogeneous attributes has long been a topic of debate among experts in the field. Among these, the concepts of reactive depression and endogenous depression, which have been distinguished by the clarity of external cause, have long been regarded by clinicians as important in the diagnosis and treatment decisions for patients. However, this pluralistic understanding has been threatened by a recent diagnostic approach represented by the DSM-5, which have adopted a phenomenological understanding rather than an etiological perspective. This study aimed to review the controversy over the monism and pluralism of depression. We discussed which perspective could be beneficial for psychologists whose role is to evaluate and treat depression and whether we could generate more comprehensive view on the issue.
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