Abnormal - discuss the relationship between etiology and treatment in depression

Question 1

etiology

Answer 1

explaining the cause o‚f a disorder

Question 2

why is determining the etiology of a disorder difficult?

Answer 2

• no simple explanations of‚ complex psychological disorder

Question 3

why should etiology be related to treatment?

Answer 3

• cause of‚ a disorder should dictate its treatment
• can be done in medicine but not possible for psychiatric disorders (e.g. depression)
• because etiologies haven’t been conclusively determined, and no definite cure has been found
• there is no clear link between serotonin levels and depression, and the fact that SSRIs can regulate serotonin levels to produce positive effects doesn’t mean low serotonin levels cause depression

Question 4

how do etiologies of depression relate to its treatment?

Answer 4

serotonin hypothesis (Coppen, 1967)

• assumes that low serotonin levels cause depression
• hence SSRIs are used to block the re-uptake process ‚of serotonin to regulate a supposed imbalance in serotonin levels
• this has been shown to improve mood
• Lacasse and Leo (2005): no evidence that depressed people have low serotonin, and the effectiveness of a treatment doesn’t imply a causal effect (e.g. aspirin alleviates headaches, but headaches are not caused by a lack of aspirin)

Question 5

effect of SSRIs on the human brain

Answer 5

Leuchter et al. (2002):

• used EEG to examine brain f€unction in 51 depression patients
• prior to EEG the patients received either an SSRI or a placebo
• placebo group showed significant increase in activity in the pre€frontal cortex throughout the trial
• SSRI group showed varying activity levels
• both groups showed similar behavioural effects (improved mood)
• the fact that the placebo group showed differences in brain activity indicates that the brain may be able to heal itself just by believing it’s being treated

Question 6

evaluation of the use of SSRIs

Answer 6

• clear that they do improve mood
• but not much is known about long-term effects of the drugs (Leuchter et al., 2002, has proven that they do affect brain activity)
•  the drugs are not a permanent cure for depression, and they have side effects
• Kirsch et al. (2008) and Leuchter et al. (2002) have shown that placebos are as effective as SSRIs in treating moderate depression
•  psychotherapy (particularly CBT) is just as effective in treating moderate depression, and significantly reduce the chances of relapse
• SSRIs appear to be necessary only for especially severe cases of depression