Classifying Depression

Question 1

Why classify depression?

Answer 1

Stimulation of research to make classification and diagnosis more reliable
Treatment can be appropriately chosen
Understanding the implications of diagnosing
Communication is easier between those working in psychopathology
Causes can be understood

Question 2

Problems classifying depression

Answer 2

Underlying cause of the disorder is not obvious

No boundaries between what is ‘ill’ and what isn’t.

Question 3

Formal diagnosis of MDD

Answer 3

Requires the presence of 5 of the following symptoms, inc depressed mood or loss of interest. These must be present for 2 weeks.

1. sad, depressed mood
2. Loss of interest/pleasure in everyday activities
3. Sleeping difficulties (too much or not enough)
4. Shift in activity level (lethargic or agitated)
5. Eating problems (too much or too little)
6. Loss of energy/fatigue
7. Negative self concept
8. Difficulties concentrating
9. Recurrent thoughts of death/suicide

Question 4

Physical symptoms of depression

Answer 4

Sleep pattern disruption, change in appetite, lack of energy

Question 5

Behavioural symptoms of depression

Answer 5

Social withdrawal, restlessness

Question 6

Cognitive symptoms of depression

Answer 6

Feeling guilty/seeing oneself as worthless

Question 7

Affective symptoms

Answer 7

Depressed mood, sadness, feeling low

Question 8

Keller et al

Answer 8

524 patients (in patients, out patients and community patients) and measured the interrater reliability of DSM-IV and the test-retest reliability 6 months later.
Result: Inter-rater reliability was high, Test-retest reliability was poor
(Problem with the reliability of DSM-IV)

Question 9

Van weel-baumgarten

Answer 9

99 patients were sent to psychologists to be diagnosed for mental health using DSM-IV.
33 had unipolar depression, 33 had anxiety disorder and 33 were mentally healthy.
Results: 28/33 depressed patients correctly diagnosed, 33/33 healthy patients were correctly diagnosed, 7/33 anxiety patients diagnosed with depression
(Problem with the validity of DSM-IV)

Question 10

Differential diagnosis

Answer 10

When mental disorders overlap and somebody is given the wrong diagnosis. Anxiety and depression have very similar symptoms but different treatments.

Question 11

Gender issues with depression

Answer 11

Women are 2x more likely to be diagnosed with depression than men. The issue with the diagnosis of depression is whether or not it is a true reflection of whether women are more depressed than men or the diagnostic tools are gender bias. When a diagnostic tool ignores gender differences it can be accused of beta bias.

Question 12

Why women may need different diagnosis to men

Answer 12

Different hormone changes
Ruminate more
Paid less and lower powered jobs
More heavily scrutinised in media

Question 13

Strengths of DSM-IV

Answer 13

• Keller, high interrater reliability
• Van Weel-Baumgarten, high diagnosis I accuracy
• Practical implications, CBT, ECT, Antidepresants
• Constantly improving

Question 14

Beck Depression Inventory

Answer 14

Diagnosis tool used to measure severity of depression
21 item questionnaire assessing a variety of depressive symptoms
A score of 30+ suggests severe depression

Question 15

Beck

Answer 15

26 outpatients and tested severity of depression using BDI one week apart
Results: 0.93 correlation suggesting it was reliable at measuring severity of depression