Table 1.

Comparison among the first (2006), second (2012), third (2017), and fourth (2021) revisions of the KMAP-DD

	First revision in 2006	Second revision in 2012	Third revision in 2017	Fourth revision in 2021
Depressive episode	Mild Moderate Non-psychotic severe Psychotic severe	Mild to moderate Non-psychotic severe Psychotic severe	Same as 2012	Same as 2017
AD dosage and duration of treatment	Present	Deletion	Change: duration of initial treatment and number of choosing AD as initial treatment	Same as 2017
Subtype	Dysthymia Minor depressive disorder Atypical features Melancholic features.	Dysthymia Minor depressive disorder Atypical features Melancholic features Seasonal pattern	Dysthymia Minor depressive disorder Atypical features Melancholic features Seasonal pattern Mixed features Anxious distress	PDD (Dysthymia) Atypical features Melancholic features Seasonal pattern Mixed features Anxious distress
Comorbid physical illness	Absent	Newly added	DM Thyroid disease Liver disease Renal disease	DM Thyroid disease Liver disease Renal disease Hypertension Seizure disorder Cardiovascular disease Parkinson’s disease Arrythmia Chronic pain (fibromyalgia, etc.)
Special population	Child only	Child and adolescent Elderly Women	Same as 2012	Child (up to primary school) Adolescent (up to high school) Elderly Women
Non-pharmacological biological therapy	ECT only	Including TMS Light therapy nutritional therapy, sleep deprivation, VNS, DBS as well as ECT	Same as 2012	ECT rTMS VNS DBS Light therapy Nutritional therapy tDCS
Response rate of review committee	66.3% (67/101)	54.5% (67/123)	54.9% (79/144)	68.5% (98/143) (adult 67.0% [65/97], child/adolescent 71.7%, [33/46])

KMAP-DD, Korean Medication Algorithm for Depressive Disorder; AD, antidepressant; DBS, deep brain stimulation; DM, diabetes mellitus; ECT, electroconvulsive therapy; PDD, persistent depressive disorder; rTMS, repetitive transcranial magnetic stimulation; tDCS, transcranial direct current stimulation; VNS, vagal nerve stimulation.