Depression - Unit 4

Question 1

Keller

Reliability of the DSM-IV

Answer 1

524 patients were sent to 5 sites to be tested for depression using the DSM-IV, then again 6 months later.
Test-retest was poor to fair over 6 months
Inter-rater was very good

Question 2

Van Weel-Baumgarten

Validity of DSM-IV

Answer 2

99 patients: 33 depressed, 33 anxiety, 33 mentally healthy
26/33 correctly diagnosed as depressed, 33/33 correctly diagnosed as healthy, 7/33 anxiety incorrectly diagnosed as depressed.
Therefore, not 100% accurate.

Question 3

McGuffin

Genes

Answer 3

One twin has depression, tested whether their twin had depression and type of twins.
Concordance rates:
MZ - 46%
DZ - 20%
There is a genetic link, however environment plays a role.

Question 4

McNeal and Cimbolic

Neurochemical explanation

Answer 4

Levels of triptafan in cerebrospinal fluid measured, those who are depressed have lower levels of triptafan.
Triptaphan is a biproduct of serotonin, so low levels of triptafan supports the low serotonin theory.
*measuring surrogate outcome as not directly measuring serotonin

Question 5

Furukawa

SSRI effectiveness

Answer 5

A meta-analysis of 35 studies found that SSRIs are significantly more effective than placebos
*should be compared to next best treatment not placebo

Question 6

Turner

Publication Bias

Answer 6

Conducted a study on all trials of antidepressants found that 37/37 studies showing effectiveness of antidepressants were published, compared to 7/33 showing antidepressants not working being published

Question 7

Kirsch

SSRI effectiveness

Answer 7

A higher sample size per study meta-analysis found that SSRIs were not significantly more effective than placebo

Question 8

Rapoport

ECT

Answer 8

Lady who tried to commit suicide several times, whom treatment hadn’t worked for
She had 8 sessions of ECT and her BDI score went from 30 to below 10
This was the same 15 months later

Question 9

Boury

Cognitive approach

Answer 9

Assessed undergrads, and found that a negative attributional style was correlated with higher BDI
(this could be bidirectional)

Question 10

Bifulco

Psychodynamic approach

Answer 10

250 women who lost mother in childhood (under 17) were 3x as likely to have anxiety or depression when grown up
*childhood was upto 4 for Freud

Question 11

Butler and Beck

CBT

Answer 11

CBT was effective in 80% of people in reducing symptoms

*Beck testing his own theory so could be investigator bias

Question 12

Svatburg and Stiles

Psychoanalysis

Answer 12

Found that psychoanalysis was no better at reducing symptoms than the control group who received nothing
*The theory has poor predictive validity

Question 13

Zhang

Genes

Answer 13

5HTT gene 3x more common in people with depression

Gene causes issues with low serotonin

Question 14

Why do we classify depression?

Answer 14

• STIMULATE new research
• to enable choosing the correct TREATMENT
• UNDERSTAND what the disease is
• to make COMMUNICATION between professionals easier
• to understand the CAUSES

Question 15

What is used to classify depression?

Answer 15

DSM-V released 2013, so most doctors use DSM-IV and most studies are on DSM-IV

Question 16

What is unipolar depression?

Answer 16

Constant low mood

Question 17

What is bipolar depression?

Answer 17

Low mood contrasted with manic phases

Question 18

What are the problems classifying depression?

Answer 18

• The underlying cause is not always obvious
• Differential diagnosis can be had to achieve
• It’s difficult to define what mental illness is, and how to differentiate between mentally healthy and mentally ill