6.2.1 Flashcards
Symptoms of Depressive Disorder (Unipolar)
Symptoms include depressed mood, reduced interest or pleasure in activities, difficulty concentrating, feelings of worthlessness, excessive or inappropriate guilt, hopelessness, thoughts of death or suicide, changes in appetite or sleep, feeling agitated, slow movements, low energy, and fatigue.
Duration of Depressive Disorder Symptoms
Symptoms must be present most of the day, nearly every day, for at least two weeks to meet diagnostic criteria for depressive disorder.
Symptoms of Bipolar Disorder
Bipolar disorder involves alternating depressive and manic episodes. Manic symptoms include euphoria, irritability, grandiosity, highly active behavior, rapid speech, rapidly changing thoughts/ideas, decreased need for sleep, distractibility, impulsivity, and recklessness.
Manic Episode Duration in Bipolar Disorder
Mania must last at least one week to meet the diagnostic criteria for bipolar disorder.
Mixed Episodes in Bipolar Disorder
In some cases, depressive and manic symptoms may be experienced within the same week or even in the same day. These are known as mixed episodes.
Beck Depression Inventory (BDI)
The BDI is a psychometric test that measures the severity of depression symptoms using 21 items scored from 0 to 3, focused on the individual’s symptoms from the last two weeks.
BDI Validity
The BDI has a positive correlation with the Hamilton Psychiatric Rating Scale for Depression, supporting its validity as an effective measure of depression severity.
ICD-11 and Mood Disorders
The ICD-11 is a classification system used for diagnosing mood disorders. It shows high inter-rater reliability (84%) for diagnosing bipolar and recurrent depressive disorders, though lower reliability (45%) for diagnosing dysthymia.
ICD-11 Reliability
Inter-rater reliability for diagnosing bipolar and recurrent depressive disorders using ICD-11 is high at 84%, but it is less reliable for dysthymia at only 45%.
BDI Self-Report Bias
As a self-report measure, the BDI may be subject to social desirability bias, leading to under-reporting or exaggeration of symptoms, which can reduce its validity.
BDI Practicality
The BDI is quick and easy to administer, providing precise data that is useful for assessing treatment efficacy in both research and clinical practice.
Quantitative Data from BDI
The BDI provides quantitative data but does not consider the contextual reasons behind an individual’s depressive symptoms, which may limit its usefulness in some cases.
Cultural Differences in Depression Diagnosis
In low-to-middle-income countries (LMICs), people with depression may report more physical symptoms (somatic symptoms), such as aches and pains, rather than the emotional or cognitive symptoms more commonly seen in high-income countries.
Individual vs. Situational Explanations of Mood Disorders
The ICD-11 views mood disorders primarily as individual differences in thinking, feeling, and behavior. However, alternative approaches, such as the trauma-informed approach, emphasize situational factors, like past experiences, in explaining mood disorders.
Diagnosis of Bipolar Disorder using ICD-11
ICD-11 helps in diagnosing bipolar disorder by considering both the presence of depressive episodes and manic episodes, with clear diagnostic criteria for each.
ICD-11 and Reliability for Dysthymia
Dysthymia, a form of chronic depression, is less reliably diagnosed using ICD-11, with an inter-rater reliability rate of only 45%.
Cultural Influences on Depression Symptoms
In some cultures, depression may manifest more through somatic complaints like fatigue or physical discomfort, rather than emotional or cognitive symptoms, affecting diagnosis and treatment approaches.
BDI and Treatment Efficacy
The BDI can help assess treatment efficacy by measuring symptom severity and tracking improvements or declines in a patient’s condition during the course of treatment.
ICD-11 and Global Use of Diagnostic Criteria
ICD-11 is used worldwide, and its reliability varies by region, with more consistent results in diagnosing bipolar disorder than dysthymia.
Beck Depression Inventory Limitations
Despite its widespread use, the BDI is limited by its reliance on self-report, which may be influenced by factors such as a person’s mood on the day of assessment or their ability to recognize and articulate their symptoms.
Social Factors in Mood Disorder Diagnosis
Situational factors, such as stress, trauma, and cultural context, can influence how symptoms of mood disorders like depression are perceived and diagnosed.
