Diagnosis and classification of depression

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  • Diagnosis and classification of depression
    • Validity
      • The extent that a diagnosis represents something that is real and distinct from other disorders and the extent that a classification such as DSM measures what it claims to measure.
      • Content validity, concurrent validity, co-morbidity
      • Gaignoses made by GP''s are made against a background of previous patient knowledge and could be biased.
      • Sub-types may not be valid because McCullough found few differences on a range of clinical, psychological and treatment  response
      • The odds of having suicidal thoughts was 5 times higher in patients with MDD alone compared to patients with no psychiatric disorder.
    • Relaibility
      • Consistency between different sets of results.
      • Test-retest, inter-rater reliability
      • Keller
        • Inter-rater reliability was 'fair-to-good' and test-retest reliability was only 'fair'.
        • May lack reliability because for MDD to be diagnosed 5 symptoms must be present and a one item disagreement is enough to make a difference between MDD and a less serious illness.
    • DSM V & ICD
      • Distinguishes between MDD and Manic Depression (bi-polar)
      • 5 symptoms must be present including depressed mood of the day, every day
      • Difficulty in sleeping, shift in activity, loss of interest & pleasure in activities, poor appetite and weight change, recurrent thoughts of death or suicide
    • Culture may impact the diagnosis of depression. White people are more likely to seek help.

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