Diagnosing Depression

At least five of the following symptoms have to have been present for the same two-week period and represent a change from previous functioning. At least one of the first two symptoms (depressed mood or loss of interest or pleasure) must be included in the symptoms.

• depressed mood most of the day, nearly every day
• loss of interest or pleasure in activities
• significant weight loss or gain
• insomnia/hypersomnia
• fatigue
• feelings of worthlessness and guilt
• diminished ability to think or concentrate
• recurrent thoughts of death and/or suicide

• The most common age of onset is late 20s
• females are more likely to get depression
• may be because of more hormones/women more likely to report
• although most major depressions disappear eventually, whether they are treated or not, relapse and recurrence are still fairly common - Coryell
• relapse = when symptoms get worse during a period of incomplete or brief recovery
• recurrence = new episode of depressive symptoms follow a period of recovery of more than two months
• depression mainly causes impaired functioning in: work, marital relationships and child/parent relationships

Kraeplin published the first recognised textbooks on Psychiatry in 1883. He believed that some groups of symptoms occur together regularly enough to have an underlying physical cause.  He stated that all mental disorders were distinct from each other with its origin, cause (aetiology), symptoms and outcome.

He believed that there are two major groups of mental illness:

• bipolar
• schizophrenia

His ideas are used in two main diagnostic manuals used today: DSM and ICD.

• It is argued that depression should not be ‘medicalised’ because all humans have mood levels – it is a natural phenomenon and it is wrong to classify it as an example of pathology but should only be diagnosed when it causes impaired functioning
• Half of the people who go to their GP with depressive symptoms are not recognised as having depression (Goldberg and Huxley). 10% of the population suffer depression but only 3% are diagnosed by GPs
• a person’s cultural background make depression more difficult to diagnose because one difference in people from non-Western cultures often present with more bodily complaints than subject distress. This could be misinterpreted if only Western-based diagnostic tools are used.- CULTURE BIAS
• it is difficult to determine whether mood disorder symptoms in a patient who has another medical condition (e.g. dementia) are secondary to the effects on the brain of the medical condition; secondary to the effects on the brain of drugs used to treat the disorder; or reflective of a primary mood disorder.
• Depression can be harder to diagnose in men because men might be less likely to admit to symptoms. However, there does seem to be a genuine difference that could be accounted for by certain psychological and biological attributes of women. – gender bias may not work for men
• Ethical because its non-invasive, unethical to allow someone to suffer without help so allows the person to receive treatment and then improve their quality of life. however may be unethical because you are giving them a label
• may not be able to diagnose correctly
• everyone interprets it differently, lowers validity