Symptoms, Causes & Features of Depression (Clinical Psychology)

Question 1

What is required for someone to be diagnosed with Depression?

Answer 1

• Presence of five or more symptoms for a 2 week period, one of which must be a depressed mood or loss of interest or pleasure.
• These symptoms must cause significant distress or impairment to the person’s life and must not be attributable to the effect of a substance or to another medical condition.
• The occurrence of the symptoms cannot be better explained as being due to a disorder from the schizophrenic spectrum, and the sufferer had never had a manic/hypomanic episode.

Question 2

What are the 4 Types of Symptoms?

Answer 2

• Emotional Symptoms
• Motivational Symptoms
• Cognitive Symptoms
• Somatic Symptoms

Question 3

What are Emotional Symptoms?

Answer 3

Those that deal with subjective states such as mood; typically in major depression the mood would be low and/or negative

Question 4

What are Motivational Symptoms?

Answer 4

To do with behaviour and the willingness to engage with the world; a persistence or determination to achieve is often missing if a person feels apathy

Question 5

What are Cognitive Symptoms?

Answer 5

Systematic changes in the way a person processes information from the world leading to a negative view of their circumstances

Question 6

What are Somatic Symptoms?

Answer 6

Changes to physiological patterns such as sleep or appetite

Question 7

What are some Other Symptoms of Depression?

Answer 7

• Significant change in weight (loss or gain).
• Changes in sleeping patterns.
• Observable psychomotor agitation.
• Fatigue Feelings of worthlessness or excessive inappropriate guilt.
• Loss of concentration.
• Recurrent thoughts of death or suicidal ideation.

Question 8

What Age is most likely to get Depression?

Answer 8

More likely to occur in young adulthood However, it can occur at any age

Question 9

What is the Course/Duration of Depression?

Answer 9

It varies…

• Some experience it, then don’t, then do again. Some experience it for a long time; especially if they have increased anxiety/personal disorders

Question 10

What is the Risk of getting Depression?

Answer 10

The risk is affected by temperament.

Neuroticism is a well-established risk factor, especially when combined with stressful life events.

Risk is increased by having negative effects in childhood and having a 1st degree relative with depression.

Question 11

What is the Prevalence Rate of Depression?

Answer 11

There are high prevalence rates, but this varies across cultures It may be due to cultural differences, and reporting how you actually feel.

• Females are more likely to get it than males

Question 12

What is meant by Neuroticism?

Answer 12

Emotional instability with anxiety, fear, depression and envy.

Question 13

What is meant by a Prevalence Rate?

Answer 13

The number of people in a given population that have the disorder at any one time.

Question 14

What Is Endogenous Depression?

Answer 14

Linked to internal biological factors, rather than being caused by an environmental trigger such as a stressful event.

Question 15

What is Borderline Personality Disorder?

Answer 15

A pattern of instability in interpersonal relationships and self-image and marked impulsivity.

Question 16

When did Kroenke’s study take place?

Answer 16

2008.

Question 17

What is the Aim of Kroenke’s (2008) Study?

Answer 17

To test whether the PHQ-8 is an accurate measure of depression by comparing it to existing diagnosis rates and the traditional psychiatric interview. To test the idea that a score of 10 or more on the PHQ would reliably indicate the presence of depression

Question 18

What is the Procedure of Kroenke’s (2008) Study?

Answer 18

Data was gathered by incorporating the PHQ-8 into a large nationwide phone survey done regularly by the USA government (the survey is called the BRFSS-the behavioural risk factor surveillance survey). The BRFSS examines health issues in the USA to help the government improve health care. In the BRFSS respondents were also asked about their quality of life, and whether they had even been diagnosed with depression. The researchers compared the PHQ-8 questionnaire to the DSM-IV structured psychiatric interview in order to test the accuracy of the PHQ-8.

Question 19

What is the PHQ-8 way of Measuring Depression?

Answer 19

The PHQ-8 is a questionnaire that assesses depression using 8 questions.

The questionnaire has a maximum score of 24.

• A score of 10 or more indicates depression, and a score of less than 10 indicates no depression.

It is quick and easy to administer.

The questions ask the respondent how often they have experienced certain events/items over the last 14 days

Question 20

What types of Events do the PHQ-8 ask respondents if they’ve experienced over the past 14 days?

Answer 20

1) Little interest or pleasure in doing things.
2) Feeling down, depressed or hopeless.
3) Sleep troubles (too much, difficulties falling or staying asleep.
4) Feeling tired or having a lack of energy.
5) Poor appetite or overeating.
6) Feeling guilty, that you are a failure, that you have let yourself and your family down.
7) Trouble concentrating e.g. reading or watching TV.
8) Moving or speaking so slowly that others notice, or the opposite being much more fidgety and restless than usual

Question 21

What is the DSM-IV Method of Measuring Depression?

Answer 21

The DSM-IV method of measuring depression involves a structured psychiatric interview based on similar ideas to those above. However it is more time-consuming than the PHQ-8.

Question 22

What were the Results of Kroenke’s (2008) Study?

Answer 22

There was high concordance between the PHQ-8 and the DSM-IV structured psychiatric interview. For example: o 176,141 (out of 198,678) participants who scored less than 10 on the PHQ-8 also showed no depression when diagnosed with the DSM structured psychiatric interview. o 8,476 people scored more than 10 on the PHQ-8 and were also diagnosed with major depression using the DSM structured psychiatric interview. Whereas none of the participants who scored less than 10 in the PHQ-8 were diagnosed with major depression using the psychiatric interview. In addition, the PHQ-8 and the DSM structured psychiatric interview were consistent with measures of quality of life. For example, those diagnosed as depressed using the psychiatric interview estimated that for 9 days out of 14 (on average) there activity was limited, whereas those with a score of 10 or more on the PHQ-8 estimated that their activity was limited for 10 days out of 14.

Question 23

What is the Conclusion of Kroenke’s (2008) Study?

Answer 23

The 2 ways of measuring depression gave similar results in terms of quality of life, social demographic characteristics and prevalence of depression. The PHQ-8 is therefore an accurate measure of depression where a score of 10 or more on the PHQ indicates the presence of depression

Question 24

What were the Advantages of Kroenke’s (2008) Study?

Answer 24

G: The sample was over 198,000 participants consisting of males and femal which is large and therefore to some extent representative of society. Therefore thefinding that the PHQ-8 is an effective way of measuring depression is generalizable to society to some extent R: Kroenke et al (2008) referenced other findings which confirm the reliability of their findings since consistent data was gathered. Martin et al found that in Germany, 7.2% of respondents had a PHQ-9 score of equal to or more than 10, which is similar to Kroenke et al’s score of 8.6 and 9.1 of the two scores used. The PHQ-9 is a similar questionnaire with one additional question related to suicidal thoughts /thoughts of self-harm). Practical Application

Question 25

What were the Disadvantages of Kroenke’s (2008) Study?

Answer 25

G: However, the sample consisted of those with phones, which excludes members of society more likely to have depression (low income, perhaps no phone) and therefore is not fully representative of society. Therefore the finding that the PHQ-8 is an effective way of measuring depression is not generalizable to the entire population R: The procedure involved comparing the PHQ-8 to the DSM structured psychiatric interview which is is not standardised. Therefore the finding that the PHQ-8 is an accurate test of depression can be replicated to achieve similar results and is not reliable V: The study and the PHQ-9 focussed on symptoms from the last 14 days, therefore it might criticised as measuring events in the respondents life rather than depression itself, and therefore lacking validity. V: All of the methods involved in the study involve self-report, and this method of gathering data has been criticised as lacking objectivity and validity. V: The researchers hadto alter the phasing of the questions of the PHQ-8 to make them consistent with the BRFSS. They changed the wording from “how often” to “for how many days out of the last 2 weeks”. This change from a qualitative to a quantitative response was not tested to see if it was valid, thereby undermining the validity of the study

Question 26

What was the Application of Kroenke’s (2008) Study?

Answer 26

The finding that PHQ-8 is effective as a method of measuring depression in populations is useful to society as it allows for the quick and relatively easy gathering of information on the mental health of society without intruding into people’s lives. This in turn allows for governments to make informed decisions in terms of where there are high levels of depression and therefore where to allocate more money to mental health services for treatments, therefore the study has application to society

Question 27

What is the Title of Kroenke’s (2008) Study?

Answer 27

The PHQ-8 as a measure of current depression in the general population