Diagnosis and Classification of Depression

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  • Created by: racheon
  • Created on: 12-01-15 14:00
What is depression classified under the DSM-IV-TR as?
A mood disorder.
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What do mood disorders affect?
Emotional state, most suffering from only depression whereas others experience states of mania as well.
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Why is symptomatogoly so important when it comes to depression?
Because the most symptoms a person has the more likely they are to suffer from depression.
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Describe mild and severe depression.
Mild depression involves being low in spirits; severe depression can make people give up the will to live so can be life-threatening.
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Where does depression rank in the top 10 causes of worldwide disability?
First.
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What must be present for the diagnosis of depression? (5)
At least 5 of the symptoms, and they must cause distress or impairment in general functioning. They can't be accounted for by bereavment. They must be present all or most of the time, and be present for longer than 2 weeks.
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What are the 9 symptoms of depression?
Sad, depressed mood; loss of interest and pleasure in usual activities; difficulties or too much sleeping; shift up or down in activity level; weight loss or gain without dieting; fatigue; negative self-concept; difficulties concentrating; suicide.
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Define reliability.
The consistency of a measuring instrument or scale to assess.
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How is reliability measured? (2)
Whether 2 independent assessors give similar diagnoses or whether tests are constant over time.
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What does Kraemer et al. note with regards to treatment and diagnosis?
That much research has been carried out on the evaluation of medical treatments but little attention has been paid to the evaluation of the quality of the diagnosis.
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What would a low level of inter-rater reliability mean for a classification procedure?
That it might lead to a faulty diagnosis and therefore inappropriate treatement.
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What did Lobbestael et al. do in their inter-rater reliability research, and what did they find?
They assessed the inter-rater reliability of the Structured Clinical Interview for the assessment of major depressive disorder in patients and non-patients, and found an inter-rater reliability coefficient of .66.
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What have field trials of the DSM emphasised?
The importance of test-retest relability, and have this as a goal for their new system.
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What did Beck et al. do in their test-retest research, and what did they find?
They studied the response of 26 outpatients tested at 2 therapy sessions 1 week apart using the BDI, and found a correlation of .93, indication a significant level of test-retest reliability.
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Define validity.
The extent that a diagnosis represents something that is real and distinct from other disorders, and the extent that a classification system measures what it claims to measure.
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How are reliability and validity linked?
A diagnosis can't be valid if it's not reliable.
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Define comorbidity.
When 2 conditions co-occur.
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Define content validity.
Whether the items in a test are representative of what is being measured.
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What depression assesment is seen to be high in content validity and why?
The BDI because it was constructed from a consensus among mental health clinicians concerning symptoms found among psychiatric patients.
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Define concurrent validity.
A measure of the extent to which a test concurs with already existing ways of assessomg the characteristic.
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What depression assessment do researchers use in concurrent validity research.
The BDI.
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What has research evidence for the DSM diagnosis found?
Inter-rater reliability is 'fair to good' and test-retest reliability is 'fair'.
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Why might the DSM lack low reliablity?
When the severity of the disorder is at the diagnostic threshold a 1 item disagreement makes the differences between a diagnosis of major depressive disorder or a less serious illness.
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What did Zimmerman claim with regards to the DSM?
That the criteria are unnecessarily lengthy and doctors have difficulty recalling all 9 symptoms, which could lead to unreliable diagnosis.
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Who backed up Zimmerman's 9 symptoms claim? Outline their study.
Krupinski and Tiller, who studied 2,500 GPs in Australia and New Zealand, and found that only one-quarter could list 5 symptoms.
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What did Zimmerman et al. do and find in light of their findings regarding the DSM?
They developed a briefer definition composed of only mood and cognitive symptoms, and found 95% agreement of diagnosis using the simplified and full definitions.
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Why are they new definitions easier to apply to ill patients?
Because it's free of somatic symptoms that are difficult to apply in patients who also have medical illnesses.
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The diagnosis of depression requires clinicians to differentiate among sub-types, however what research disproves the theory of sub-types?
McCullough et al. compared 681 outpatients with various types of depression and found few differences on clinical, psychosocial and treatment response, suggesting that distinctions between sub-types may not be valid.
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Are GP diagnosis valid? Use relevant research in your answer.
For most people a diagnosis is given by a GP, however van Weel-Baumgarten et al. suggests that diagnoses made by GPs are made against a background of patient knowledge and could be biased.
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What are the consequences of cormorbidity?
Cormorbidity has shown to have a negative impact on social and occupational functioning and poorer response to treatment.
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What are the similarities and differences between the DSM and the ICD.
Research has show that the concordance is 75%. The major difference is ICD requires 2 of 3 symptoms, however Andrews et al. demonstrated that this difference doesn't produce discrepant diagnosis, therefore 1 system can't be regarded as more 'valid'.
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Who did research into DSM reliability for major depressive disorder and dysthymia and what did they do?
Keller et al. carried out a multi-site study by recruiting 524 individuals and interviewing them using the DSM, then again 6 months later to establish test-retest reliability.
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What did Keller et al. find after their research?
Inter-rater reliability was 'fair to good', but test-retest reliability was 'fair' for dysthymia and 'poor to fair' for major depression.
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What is the main cultural difference in the diagnosis of depression?
Ethnic minorities are less likely than middle-class white people to seek treatment for depression.
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Other cards in this set

Card 2

Front

What do mood disorders affect?

Back

Emotional state, most suffering from only depression whereas others experience states of mania as well.

Card 3

Front

Why is symptomatogoly so important when it comes to depression?

Back

Preview of the front of card 3

Card 4

Front

Describe mild and severe depression.

Back

Preview of the front of card 4

Card 5

Front

Where does depression rank in the top 10 causes of worldwide disability?

Back

Preview of the front of card 5
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