 |
|
Are too many people diagnosed as 'depressed?'
August 17, 2007Head-to-head: Is depression over-diagnosed?
Are too many people now diagnosed as having depression? Two experts give their views in this week's BMJ.
Professor Gordon Parker, a psychiatrist from Australia says the current threshold for what is considered to be 'clinical depression' is too low. He fears it could lead to a diagnosis of depression becoming less credible.
It is, he says, normal to be depressed and points to his own cohort study which followed 242 teachers. Fifteen years into the study, 79% of respondents had already met the symptom and duration criteria for major, minor or sub-syndromal depression.
He blames the over-diagnosis of clinical depression on a change in its categorisation, introduced in 1980. This saw the condition split into 'major' and 'minor' disorders. He says the simplicity and gravitas of 'major depression' gave it cachet with clinicians while its descriptive profile set a low threshold.
Criterion A required a person to be in a 'dysphoric mood' for two weeks which included feeling "down in the dumps". Criterion B involved some level of appetite change, sleep disturbance, drop in libido and fatigue. This model was then extended to include what he describes as a seeming subliminal condition "sub-syndromal depression."
He argues this categorisation means we have been reduced to the absurd. He says we risk medicalising normal human distress and viewing any expression of depression as necessary of treatment. He says:
"Depression will remain a non-specific 'catch all' diagnosis until common sense prevails."
On the other side of the debate Professor Ian Hickie argues that if increased diagnosis and treatment has actually led to demonstrable benefits and is cost effective, then it is not yet being over diagnosed.
He says increased diagnosis and treatment has led to a reduction in suicides and increased productivity in the population. Furthermore the stigma of being 'depressed' has been reduced and the old demeaning labels of 'stress' and 'nervous breakdown' have been abandoned.
He says concerns about the number of new drug treatments on the market are unhelpful, arguing that new drugs to treat depression have reduced the prescribing of older, more dangerous sedatives and says that the consequences, such as suicide, of not being diagnosed or receiving treatment are rarely emphasised.
Audits carried out in the UK, Australia and New Zealand do not support the notion that the condition is over diagnosed, far from it, he says. Instead he points to the diagnosis rate of people with major depression and says this needs to be improved in which case rates of diagnosis must continue to rise.
BMJ-British Medical Journal
It is, he says, normal to be depressed and points to his own cohort study which followed 242 teachers. Fifteen years into the study, 79% of respondents had already met the symptom and duration criteria for major, minor or sub-syndromal depression.
He blames the over-diagnosis of clinical depression on a change in its categorisation, introduced in 1980. This saw the condition split into 'major' and 'minor' disorders. He says the simplicity and gravitas of 'major depression' gave it cachet with clinicians while its descriptive profile set a low threshold.
Criterion A required a person to be in a 'dysphoric mood' for two weeks which included feeling "down in the dumps". Criterion B involved some level of appetite change, sleep disturbance, drop in libido and fatigue. This model was then extended to include what he describes as a seeming subliminal condition "sub-syndromal depression."
He argues this categorisation means we have been reduced to the absurd. He says we risk medicalising normal human distress and viewing any expression of depression as necessary of treatment. He says:
"Depression will remain a non-specific 'catch all' diagnosis until common sense prevails."
On the other side of the debate Professor Ian Hickie argues that if increased diagnosis and treatment has actually led to demonstrable benefits and is cost effective, then it is not yet being over diagnosed.
He says increased diagnosis and treatment has led to a reduction in suicides and increased productivity in the population. Furthermore the stigma of being 'depressed' has been reduced and the old demeaning labels of 'stress' and 'nervous breakdown' have been abandoned.
He says concerns about the number of new drug treatments on the market are unhelpful, arguing that new drugs to treat depression have reduced the prescribing of older, more dangerous sedatives and says that the consequences, such as suicide, of not being diagnosed or receiving treatment are rarely emphasised.
Audits carried out in the UK, Australia and New Zealand do not support the notion that the condition is over diagnosed, far from it, he says. Instead he points to the diagnosis rate of people with major depression and says this needs to be improved in which case rates of diagnosis must continue to rise.
BMJ-British Medical Journal
Depression Current Events and Depression News RSSTwo From One-Pitt Research Maps Out Evolution of Genders From Hermaphroditic Ancestors
Research from the University of Pittsburgh published in the Nov. 20 edition of "Heredity" could finally provide evidence of the first stages of the evolution of separate sexes, a theory that holds that males and females developed from hermaphroditic ancestors.
Prognosis after attempted suicide impaired by psychiatric disorder
People who have attempted suicide at some point in their lives are more likely to actually succeed in committing suicide at a later date.
Routine Testing After Aneurysm Coiling Carries Low Risk
A very low risk of complication is associated with a routine test that determines whether a brain aneurysm treated with endovascular coiling has started to recur, a study led by the University of Cincinnati Neuroscience Institute has shown.
Methamphetamine abuse linked to underage sex, smoking and drinking
Teens who have never done drugs, but engage in other risky behaviours such as drinking, smoking and being sexually active, are more likely to use crystal meth, medical researchers at the University of Alberta have concluded.
Physical activity after bariatric surgery improves weight loss, quality of life
A new study by researchers from The Miriam Hospital's Centers for Behavioral and Preventive Medicine suggests increased physical activity after bariatric surgery can yield better postoperative outcomes.
Adalimumab may reduce health-care costs for Crohn's disease patients
Inflammatory bowel disease (IBD) is a term that refers to both ulcerative colitis (UC) and Crohn's disease (CD). IBD occurs most frequently in people in their late teens and twenties. There have been cases in children as young as two years old and in older adults in their seventies and eighties; men and women have an equal chance of getting the disease.
Pivotal Emory study focuses on teens at risk for psychosis
Emory University in Atlanta is playing a key role in the largest, most comprehensive study ever funded by the National Institute of Mental Health (NIMH) of adolescents and young adults at risk for developing a psychotic disorder.
SNPs affect folate metabolism in study of Puerto-Rican adults
Researchers at Tufts University have gained further understanding of the genomic basis for altered folate metabolism and the content of uracil in blood DNA.
Babies placed in incubators decrease risk of depression as adults
Babies who receive incubator care after birth are two to three times less likely to suffer depression as adults according to a new study published in the journal Pyschiatry Research.
Mental health linked to stillbirth and newborn deaths
Women with a history of serious mental illness are much more likely to have babies that are stillborn or die within the first month of life, new research reveals.
More Depression Current Events and Depression News Articles
 | The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by J. Mark G. Williams, John D. Teasdale, Zindel V. Segal, Jon Kabat-Zinn The Mindful Way through Depression draws on the collective wisdom of four internationally renowned cognitive therapy and mindfulness experts, including bestselling author Jon Kabat-Zinn, to help you break the mental habits that can lead to despair. This authoritative, easy-to-use self-help program is based on methods clinically proven to reduce the recurrence of chronic unhappiness. Informative... |
 | The Forgotten Man: A New History of the Great Depression by Amity Shlaes In The Forgotten Man, Amity Shlaes, one of the nation's most-respected economic commentators, offers a striking reinterpretation of the Great Depression. She traces the mounting agony of the New Dealers and the moving stories of individual citizens who through their brave perseverance helped establish the steadfast character we recognize as American today.... |
 | Rethinking the Great Depression (American Ways Series) by Gene Smiley Drawing upon recent economic scholarship to present a clear and nontechnical analysis, Mr. Smiley offers new insights and some surprising conclusions about the causes of the Great Depression, the consequences of the New Deal, and the economic effects of World War II. An accessible survey...challenges the popular belief that the Great Depression demonstrates the instability of markets and the need... |
 | Essays on the Great Depression by Ben S. Bernanke Few periods in history compare to the Great Depression. Stock market crashes, bread lines, bank runs, and wild currency speculation were worldwide phenomena--all occurring with war looming in the background. This period has provided economists with a marvelous laboratory for studying the links between economic policies and institutions and economic performance. Here, Ben Bernanke has gathered... |
 | The Great Depression: America 1929-1941 by Robert S. Mcelvaine A perennial backlist... |
 | The Return of Depression Economics and the Crisis of 2008 by Paul Krugman In 1999, in The Return of Depression Economics, Paul Krugman surveyed the economic crises that had swept across Asia and Latin America, and pointed out that those crises were a warning for all of us: like diseases that have become resistant to antibiotics, the economic maladies that caused the Great Depression were making a comeback. In the years that followed, as Wall Street boomed and financial... |
 | Unstuck: Your Guide to the Seven-Stage Journey Out of Depression by James S. Gordon M.D. A groundbreaking, inspiring, and practical guide to healing depression without the use of antidepressants, from world-renowned, Harvard trained psychiatrist Dr. James S. Gordon Each year, as many as twenty million Americans are diagnosed with clinical depression. Tens of millions more have low energy or feel unhappy and dissatisfied with their lives. And each year, American doctors write 189... |
 | The Great Depression and the New Deal: A Very Short Introduction: A Very Short Introduction (Very Short Introductions) by Eric Rauchway The New Deal shaped our nation's politics for decades, and was seen by many as tantamount to the "American Way" itself. Now, in this superb compact history, Eric Rauchway offers an informed account of the New Deal and the Great Depression, illuminating its successes and failures. Rauchway first describes how the roots of the Great Depression lay in America's post-war economic policies--described... |
 | The Great Crash of 1929 by John Kenneth Galbraith Of Galbraith's classic examination of the 1929 financial collapse, the Atlantic Monthly said:"Economic writings are seldom notable for their entertainment value, but this book is. Galbraith's prose has grace and wit, and he distills a good deal of sardonic fun from the whopping errors of the nation's oracles and the wondrous antics of the financial community." Now, with the stock market riding... |
 | Undoing Depression by Richard O'Connor For some people, depression has been a part of their experience for so long that they've begun to believe it's what they are. They become experts at "doing" depression--hiding it, working around it, even achieving great things (but at the price of great struggle, and little satisfaction). In this book, psychotherapist Richard O'Conner shows us how to "undo" depression, by replacing depressive... |
| © 2008 BrightSurf.com |