PSYA4 Depression

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  • Classification of Depression
    • Validity
      • A01
        • Validity is another issue which refers to the extent that the diagnosis represents something that is real and claims what it set out to test.
        • Concurrent validity also poses an issue, it is the measure of the extent to which a test agrees with already existing ways so it compares a new method with one already existing.
        • Commorbidity is a big issue as it is important because it refers to the extent to which two or more conditions overlap. However, there may be consequences of commorbidity as it has been shown to have a negative impact on social and occupational functioning.
        • A factor that causes a problem in the diagnosis of depression is content validity which is whether the items in a test are representative of what is being measured and examining the content of the test to see if it looks like it measures what it is supposed to. This is an issue because if a test doesn't test what it is supposed to, it isn't valid.
      • A02
        • Most of the diagnostics of depression is given by a GP. However, Van weel-baumgarten suggests that a diagnosis made by a GP are made by background of previous patient knowledge. Therefore, this could have a consequence of a biased and inaccurate diagnosis because it is subjective which makes it invalid.
        • Godwin found that the odds of having suicidal thoughts were five times higher with major depression than compared to patients with no psychiatric disorder. However, patients with major depression combined with panic disorder had triple that ratio. This suggests that there may be some major consequences when conditions overlap.
        • There may be cultural differences in the diagnosis of depression. Ethnic minority groups in the UK are less likely than white people to seek help for depression. There is a stigma attached to mental disorders in some cultures, they see it as a social problem. Whereas, white people see it as an illness and are willing to get help. Therefore, this suggests that there is a difference in the diagnosis of depression and how people deal with it.
    • Depression is an affective mood disorder (the most common) and the symptoms consist of sad or depressed mood, poor appetite / weight loss and recurrent suicidal thoughts.
    • The diagnosis of depression comes from the DSM and the ICD, to be diagnosed with depression you need to have 5 out of 9 of the criteria.
    • Reliability
      • A01
        • An issue related to the classification and diagnosis is reliability which refers to the consistency of the same results through questionnaire.
        • Inter-rater is one issue and low levels in relation to any classification procedure may lead to a faulty diagnosis and inappropriate treatment.
        • Another issue is test-retest reliability because it is important to retest questionnaire when being used as an diagnostic tool to check reliability as inaccurate questions may lead to inaccurate diagnosis.
      • A02
        • Keller looked at reliability using the DSM and found that inter-reliability was 'fair to good' this may be because for a diagnostic  of major depression 5 out of 9 symptoms must be present. So, for the importance of diagnosis of depression, this is not very good as it could lead to a consequence of a subjective diagnosis of depression which suggests this is an issue of the diagnosis of depression.
          • Thus, this creates an issue with reliability for the diagnosis of depression because the wrong treatment may be given to the patient which may make symptoms worse.
        • Keller suggested a number of reasons why the DSM diagnosis of depression may lack reliability. For a major depression diagnosis, a min of 5 out of 9 symptoms must be present but when the severity of the disorder is at one item difference between a major diagnosis and a less serious illness may lead to a wrong diagnosis.
          • Thus, this creates an issue with reliability for the diagnosis of depression because the wrong treatment may be given to the patient which may make symptoms worse.


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