Classification and Diagnosis of Depression

The clinical characteristics of depression are sad depressed mood, most of the day, nearly every day for two weeks, or loss of interest and pleasure in usual activities. There is also difficulties in sleeping (insomnia); not falling asleep initially; not returning to sleep after awakening in the middle of the night, and early morning awakenings; or, in some patients, a desire to sleep a great deal of the time. A shift in activity level and feeling lethargic or agitated is also a common symptom.

Poor appetite and weight loss or increased appetite and weight gain is a physical symptom of depression. You may also experience loss of energy and great fatigue. A negative self concept, self blame and feelings of worthlessness and guilt with further evidence being difficulty in concentrating, such as slowed thinking and indecisiveness. Recurrent thoughts of death or suicide is the main symptom and finally apathy (no interest or pleasure in activities).

There are two types of unipolar depression according to the classification systems. The first is major depressive disorder and the other is dysthymic disorder. Patients with MDD require five symptoms, suicidal thoughts. The symptoms are severe but can be short lived. On the other hand DD requires three or more symptoms, including depressed mood but not suicidal thoughts. Patients cannot be without these symptoms for more than two months.

There is also a distinction between two types of depression that is embedded within psychiatric thinking. These are endogenous, which is referred to depression arising from biochemical disturbances in the brain. It is thought to arise from within the person, independent of external events or reactive (exogenous) referred to depression arising from external events such as a reacton to stressful events outside ourselves e.g. the death of someone close, redundancy or failing exams.

Discuss issues surrounding the classification and diagnosis of depression (20) Classification is what for example botanists do when they differentiate between types of flowers (roses as distinct from orchids) and variations within those categories (e.g. different kinds of roses).Classification is decoding what depression is and what the characteristics of the different types of depression are. Diagnosis is when botanists look at one particular flower and decide thats it characteristics identify it as a rose (as oposed to a tulip). In the field of mental health, diagnosis is the clinical judgement that a particular person is suffering, for example from depression.

Reliability of psychiatric diagnosis is the extent to which a classification system repeatedly produces the same outcome. More specifically in relation to mental health workers, inter rater reliability is the extent to which two independent clinicians agree about the diagnosis of a person using the DSM as criteria with a mental health problem such as depression. Validity of the systems in measuring what they set out to measure (the correct symptoms and duration) for diagnosis of depresion. They should make sure the universal definition will match to someone who has depression and if they do not have enough symptoms or similar symptoms then they cannot be classified as having depression.

Rosenhan’s study has changed the classifications systems vastly. Nine healthy people presented themselves at different psychiatric hospitals and said that they were hearing voices saying things like ’empty and ‘thud’. All were admitted and all, except one were diagnosed as suffering from schizophrenia. Apart from changing their names and jobs, all other information given to the clnicians at the hospitals thereafter was true. As soon as they were admitted to psychiatric wards, all eight stopped simulating any symptoms of abnormality. The pseudopatients were never detected and were eventually discharged with the diagnosis of schizophrenia in remission. Length of hospitalisation ranged from 7 to 52 days (average 19). Perhaps most interesting though, is the fact that several fellow patients (35 out of 118 in the first three hospitalisations, when detailed records were kept by the pseudopatient) ‘detected their sanity’.

In this assignment the Author intends to discuss, evaluate and research the reliability and validity of diagnosis and classification, demonstrate and recognise the values and limitations required when discussing psychological disorders and finally conclude by writing an essay identifying how …

On the basis of what happened in each of these cases, Rosenhan suggested that psychiatrists are unable to determine who is and who is insane. Rosenhans study made a deep impact on the classification of mental illness and was taken …

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