Prevalence of rates & disorders Flashcards
Kessler & Bromet aim
to compare the prevalence of depression across cultures
Kessler & Bromet method
review of publications containing epidemiological data (epidemiological surveys)
- epidemiological data refers to the frequency of a disease in a given population
Kessler & Bromet results
- MDD is found in all countries where epidemiological surveys were carried out
- lifetime prevalence estimates for MDD varied widely Czech Republic 1% to USA 16.9%
- 12 month prevalence ranged from 0.3% to 10%
- age of onset is similar in high-income & low-income countries
- sociodemographic correlates of depression are also fairly consistent across cultures. E.g women’s risk for developping MDD is typically twice that of men
Kessler & Bromet conclusion
- prevalence rates of MDD vary considerably across cultures
- this may be due to a variety of factors including the classification of the system in use, the survey used to establish the systems, representativeness of the samples used in research as well as true prevalence
- the highest prevalence estimates are found in some of the wealthiest countries in the world
- the authors suggest that this may be due to income inequality, but this requires further explanation
Diagnosis of MDD symptoms
- depressive moods
- diminished interest or pleasure in daily activities
- significant weight change - loss or gain
- insomnia or hypersomnia
- fatigue
- feeling worthless or guilt
- diminished ability to think or concentrate
- recurrent suicidal thoughts
Criteria for the diagnosis of MDD
- 5 + of the listed symptoms have been present for 2 weeks
- these symptoms represent a change from previous functioning
- at least 1 of the symptoms is either depressed mood or loss of interest or pleasure
- symptoms cause significant distress or malfunctioning
- the symptoms are not attributable to (or better explained by) other conditions and disorders
Bereavement exclusion
- a condition that existed in the DSM-IV & stated that depression cannot be diagnosed if symptoms occur less than 2 weeks after a significant loss, such as the death of a close person (this condition was removed from the DSM-5)
- this makes diagnosis of depression in DSM-5 more inclusive than it used to be in the DSM-IV: a larger number of ppl can now be diagnosed in the bereavement period
Furnham & Malik aim
to investigate cross-cultural beliefs about depression
Furnham & Malik background
statistically, British asians are rarely diagnosed w depression - possible explanation for this is that they have it but fail to report it
Furnham & Malik participants
152 females in 2 age groups → young & middle aged, half of the participants are native British, other half was asian origin
Furnham & Malik method
quasi experiment
Furnham & Malik procedure
- participants filled out questionnaires about their symptoms of mental illness & their beliefs about depression
- responses were compared across groups (the 2 IVs were culture & age)
Furnham & Malik results
- perception of depression differed among asian & British participants
- e.g asian participants(but not British) believed depression is temporary & can be fixed by having a job outside home
- these differences were less pronounced in the group of younger women
- asian middle-aged women reported being depressed significantly less than the younger group
Furnham & Malik conclusion
- cultural differences exist in the way depression is perceived
- these differences may be due to underlying cultural dimensions (such as individualism vs collectivism)
- cultural differences influence the rates at which disorders are reported
- globalisation gradually erases these cultural differences, w younger generations having less reporting bias
Furnham & Malik aim
to investigate cross-cultural beliefs about depression
Furnham & Malik method
quasi experiment
Furnham & Malik procedure
- participants filled out questionnaires about their symptoms of mental illness & their beliefs about depression
- responses were compared across groups (the 2 IVs were culture & age)
Furnham & Malik results
-
perception of depression differed among asian & British participants
- e.g asian participants(but not British) believed depression is temporary & can be fixed by having a job outside home
- these differences were less pronounced in the group of younger women
- asian middle-aged women reported being depressed significantly less than the younger group
Furnham & Malik conclusion
- cultural differences exist in the way depression is perceived
- these differences may be due to *underlying cultural dimensions (such as individualism vs collectivism)
- cultural differences influence the rates at which disorders are reported
- globalisation gradually erases these cultural differences, w younger generations having less reporting bias
Onset age
The average age when individuals in a population are first diagnosed
Classification system
A diagnostic manual providing a system of diagnostic categories, a set of symptoms for each diagnostic category, and rules for making a diagnosis based on these sets of symptoms.
Lifelong prevalence
The percentage of people who have had the diagnosis at some point in their lifetime
Major Depressive Disorder (MDD)
A mental health disorder characterised by persistent depressive moods and loss of interest in pleasure which can have significant impact on an individual’s daily life.
It is categorised into 4 different sections: emotional, physiological, cognitive and behavioural. To be diagnosed by a clinician, one must have at least 5 of the identified symptoms over the same 2-week period.
Factors influencing prevalence rate estimates
classification system
clinical biases in diagnosis
cultural differences
gender & age differences
classification system - diagnosis is based on it
- diagnosis is on the basis of a list of symptoms & diagnostic criteria
- these may be subject to change w every subsequent edition of the diagnostic manual (e.g bereavement exclusion MDD was removed from the DSM-5)
- it needs to be understood that there is no such thing as prevalence rates independent of a classification system
- these may be subject to change w every subsequent edition of the diagnostic manual (e.g bereavement exclusion MDD was removed from the DSM-5)
clinical biases in diagnosis
- some populations may experience depressive symptoms but be reluctant to report them - known as reporting bias
- in some societies it might be shameful to have depression
- it needs to be understood that prevalence rate estimates are based on the number of ppl who sought psychological help & were diagnosed w a disorder, but societies differ considerably in terms of the amount of ppl who are likely to seek psychological help in the first place
- in some societies it might be shameful to have depression
cultural differences
- Symptoms may be different for the same disorder among different cultures.
- cultural variations in the expression of symptoms → even if ppl do report their symptoms, they may present them differently in a clinical situation, which (depending on the training of the psychiatrist) may lead to bias in diagnosis
gender & age differences
- Symptoms of depression may present themselves differently in different populations
- Men - tiredness, irritability, anger
- Women - sadness, worthlessness, guilt
- Adolescents - irritability and face disciplinary issues at school→ comorbid with anxiety and eating disorders and substance abuse
- Younger children - separation anxiety and school refusal
period prevalence
the proportion of people in a given population who have the disorder within a given time interval; typically used periods are 12-month prevalence, lifetime prevalence
point prevalence of a disorder
the proportion of people in a given population currently diagnosed with the disorder
