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PSYD33H3 (9)

PSYD33 - Coyne notes for paper

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Michael Bagby

st1 rebuttal in RDC DSM3DSM3R the diagnosis of depression is based on mood disturbanceVredenburg criticize these instrumentshe said the RDC DSM3 require sad mood for a diagnosis of depression in fact they require evidence of sustained mood disturbance but this can be met by apathy or loss of interestpleasure in almost all activities this primary symptom of depression isnt given enough weight in selfreport measures of distress and bc of respondents lack of comprehension it is difficult in obtaining reliable and valid assessments w selfreport measures yet 1015 of severely depressed patients deny feelings of sadness and meet the mood criterion ALSO a diagnosis of depression doesnt currently require that a person have sought help or be suffering marked impairment of functioningthis requirement was dropped from DSMIII bc it seemed superfluous reinstatement of the impairment criterion might improve predictive validity of diagnosis of major depression for DSMIV for diagnosis of MD DSMIIIR requires depressive symptoms in addition to either depressed mood or markedly diminished interestpleasure in activities for most of the day nearly every day for a minimum of 2 weeks counting such mood disturbance the person must have a total of at least 5 symptoms for a 2week period from a list clinical depression is associated w greater functional impairment than a variety of chronic medical conditions one unfortunate result of using college students as surrogates for clinical depressed persons has been a downplaying of the enourmous personal and social costs of depressionnd2 rebuttal refinement of criteria has stimulated development of structured assessment toolsie SADS DIS and SCID contrary to Vredenburg SADS is no longer used and SCID is used instead which has been oriented to DSM3R criteria he overlooked SCID and instead recommended DIS which has a reliance on respondent selfreport for diagnosisDISwhich was initially designed to enable lay interviewers to obtain psychiatric diagnoses comparable to those in psychiatrist would obtain but performance of DIS falls short DIS relied heavily on respondents understanding of concepts and ability to judge their symptomsadvantages of DIS refutes the criticism mentioned earlier there is one treatment study that has initiated a 3stage selection processppl who score high on selfreport are administered DIS and then if they appear depressed a clinical interview by psychiatristLow Prevalence Rates basicaly saying there is a very low prevalence of depression among general pop BUT possibility that DIS overdiagnoses depression highlights greater prevalence of depressive symtoms there is a diference in prevalence of symptoms and diagnosable depressionAssessing Selfreported Distress BDI BDI was not originally designed for college studentsand its conventional cutpoints have never been validated for use in this populationhigh scores on BDI for uni students shouldnt be interpreted as indicative of depression
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