Davidson and Neal - Asian cultures, praised for not showing emotional turmoil and so often sufferers show physical symptoms. Kua - 72% of people in China presented with head/stomach/chest pain later diagnosed with mental health problem
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Reliability in Diagnosis
Beck - compared two psychiatrists who diagnosed 154 patients, only 54% diagnosed reliably by both
Weissman, Kidd and Prusoff - 2x more depressives of relatives already suffering compared to relatives of non-sufferers, McGuffin - 214 pairs of twins, MZ=46%, DZ=20%, Wendler - Biological relatives of adopted sufferers 7x more likely to suffer
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Bio-Chemicals
Wender and Klein - drugs to rats that lowered noradrenaline, became sluggish/inactive. Reboxetine - increases noradrenaline, Prozac - increases serotonin, Mintun - PET scans,depressed people have fewer serotonin receptors
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Effectiveness of Drugs
Arroll - drugs reduces symptoms more than placebo, Kirsan - only in severe depression are SSRI's better than placebo, Derublis - drugs vs cognitive, 58% reduction, Hollon - cognitive relapse = 31%, drug=47%
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Appropriateness of Drugs
Montgomery - SSRIs are better tolerated that TCAs, Barbui - reviewed studies, SSRIs increase suicide risk in adolescents but reduce in adults, best for 65+
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Effectiveness of ECT
Gregory - fake ECT vs real ECT, benefited from real, Folkerts - for treatment resistant depression, Hussain - no benefits of ECT, Scott - reviews 18 studies, ECT more effective in the short term
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Appropriateness of ECT
Rose - 1/3 of patients experience persistent memory loss after ECT. Department of Health Record - 30% reported permanent anxiety and fear after ECT
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Cognitive model
Mezulis - parental style did not effect negative cognitive style, Lewinsohn - students, more vulnerable to depression following stress if they already have negative cognitive style. Evans - highest score=60% more likely to suffer, predicted 3 years
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Effectiveness of CBT
Rush-at least as effective as drug therapy, Blackburn and Moorehead -significantly superior to drugs, NICE - most effective treatment, Butler - 16 meta analysis, very effective, Hollon -31% relapse, Holmes - selective sampling
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Psycho dynamic Approach
Bifulco - some people who experience childhood loss become depressed. Bonano - claims it is as few as 10%
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Effectiveness of Psych dynamic Treatment
Eysenck - 2 studies, control group awaiting treatment, 66% control improved while 44% psychodynamic improved. Bergin - reviewed original data, control were receiving treatment. Burnard - 74 patients drugs and psychotherapy show best improvement
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Front
Reliability in Diagnosis
Back
Beck - compared two psychiatrists who diagnosed 154 patients, only 54% diagnosed reliably by both
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