Classification and Diagnosis of Depression
Outline the clinical characteristics of depression (5) 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
Explain Issues Associated With The Classification And/Or Diagnosis Of Depression.
EXPLAIN ISSUES ASSOCIATED WITH THE CLASSIFICATION AND/OR DIAGNOSIS OF DEPRESSION (10 MARKS) There are many issues with the classification and diagnosis of depression. One issue is the fact that there are some people who strongly believe that depression should not be medicalised. They argue that all humans have mood levels, so it is very natural for someone’s mood to go up and down- people can recover without medical treatment. However, there are also others who argue mood can show extreme manifestations and can serious illnesses which could then potentially lead to death, so they argue that depression should be medicalised- it should be treated in the same way you would treat other physical changes such as sugar levels and high temperature. Another issue is the fact that it can prove to be rather difficult to make distinctions between types of depressions. For example, a person who is suffering from bipolar may have the same symptoms as a person who is suffering from unipolar, so a person could potentially end up being misdiagnosed and be given treatment which may have no effect on the depression that they are suffering from. Another issue is the fact that depression can remain under diagnosed in children because the symptoms are displayed differently in children. The depressive symptoms in children are irritability rather than low mood. Irritability can also be a
Dual Diagnosis: Schizophrenia and Substance Misuse
Dual Diagnosis: Schizophrenia and Substance Misuse Schizophrenia is a serious mental health disorder affecting 1% of the population, but incurs a considerable cost for the health care system due to its chronic nature. It represents a significant issue to the community as the illness not only affect the patients themselves, but also their families and friends in terms of care and social support. Schizophrenia involves many non-medical problems to the patient and his/her carers, such as prejudice and stigma by a public who is poorly educated in regards to mental illness. Some patients find themselves rejected by employers who're either fearful, or unwilling to hire a worker who they see as a burden to them. Thus, many chronically ill patients are caught in a deteriorating social cycle, falling into homelessness, or into crime and end up in the prison system. Patients who develop depression in association with schizophrenia also risk self-harm and suicide. All these problems are compounded in patients with a dual diagnosis, who have a second disorder, most often substance abuse. Dual diagnosis is, unfortunately, all too common among schizophrenic patients, who have a four-fold risk of drug use [1], and approximately 50% become involved in substance abuse at some point during their illness [2]. Dual diagnosis shows a male predominance, especially in 18 to 25 year olds.
Discuss cultural and ethical considerations in diagnosis of abnormal psychology.
Discuss cultural and ethical considerations in diagnosis. Abnormal psychology is the area of psychology which concentrates on unusual behaviours. These could involve affective disorders such as depression or anxiety. It is not an exact science since in different parts of the world different things are considered abnormal. This often leads to the need of having cultural considerations. These types of considerations come up when disorders which “exist” in certain parts of the world only are taken into consideration. Rack in 1982 considered for example the fact that in China diagnosis are made only in severe cases since the mentally ill are not easily accepted there. Also Kleinman in 1984 evaluated how often symptoms are bound to certain cultures and not to others. Ethical considerations instead are made so to have the least amount of counter effects as possible in the patient who is given a diagnosis of a mental disease. Szasz for example stated that often labels are given to people (such as mentally ill) so to isolate them. Another study considered how isolating patients in institutes can be ethically unjust since it causes several problems both for the doctor and for the patient. This was the study conducted by Rosenhan in 1973. Culture affects diagnosis. This is caused by the fact that the standards for abnormality differ from culture to culture and from society to
Clinical characteristics of depression
(a) Outline the clinical characteristics of depression (b) Explain the issues associated with the classification and diagnosis of depression (24 marks) Depression is a collection of physical, mental, emotional and behavioural experiences that are more prolonged, severe and damaging. The medical model involves individuals going to the doctors and having their physical symptoms observed and questions asked about their illness/problem. To help doctors diagnose diseases such as mood disorders, the medical classifications ICD-10 and DSM-IV both define these diseases in order for doctors to follow the guidelines and diagnose the correct illness. A person is defined as having a mild depressive episode of depression by the International Classification of Diseases 10th edition by having two or three of the following psychological symptoms; lowering of mood, reduction of energy, decreased activity, ideas of guilt and worthlessness, capacity for enjoyment, interest and concentration is almost always lowered, appetite diminished, sleep disturbed and self-esteem and self-confidence is lowered. These psychological symptoms may also be accompanied by somatic symptoms such as; lowering of mood, waking hours before normal in the morning, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, loss of libido and weight loss. To be diagnosed as
Issues associated with the classification and diagnosis of schizophrenia
Discuss issues associated with the classification and/or diagnosis of schizophrenia. An important aspect of any classification system is its reliability, high inter-rater reliability is important as it means that each time the system is used it has the same outcome. There has been little consistency in the diagnosis of schizophrenia in the past due to vagueness of the classification systems and inconsistencies between them, it is difficult to achieve reliable diagnosis when there is no universally agreed definition of schizophrenia. In order to improve reliability of diagnosis a group of symptoms characteristic of schizophrenia but rarely found in other mental disorders were identified as first rank symptoms, these form the basis of the current DSM and ICD and have helped reduce misdiagnosis. However DSM and ICD systems do still differ in a few key ways, for example in the length of time symptoms have to be present for diagnosis, ICD is one month while DSM is six months, this is a significant difference given how quickly severe symptoms can present in acute onset schizophrenia. Another important issue in classification is the validity of the classification system, this is the degree to which the system measures what it set out to measure, in this case it refers to the appropriateness of the categories in diagnosing schizophrenia. Reliability can still be high if the
Discuss issues relating to the classification and diagnosis of schizophrenia
Discuss issues relating to the classification and diagnosis of schizophrenia Schizophrenia is a serious mental disorder characterised by a profound disruption of cognition and emotion, which affects a person’s language, thought, perception, affect and even sense of self. In most countries across the world, the lifetime risk of being diagnosed with schizophrenia is 1 per cent. There is a distinction between acute and chronic onset schizophrenia. In chronic onset, there is often an insidious change in an apparently normal young person who gradually loses drive and motivation and starts to drift away from friends. After months, or even years of this deterioration, more obvious signs of disturbance such as delusional ideas or hallucinations, appear. In acute onset, obvious signs such as hallucinations can appear quite suddenly, usually after a stressful event, and the individual shows very disturbed behaviour within a few days. In terms of symptoms that are used in diagnosis and classification, there are positive symptoms, which reflect an excess or distortion of normal functions, hallucinations, delusions, experiences of control and disorganised thinking. There are also negative symptoms which in fact reflect a loss or reduction in normal functions e.g. alogia (the loss of fluent speech) avolition (the loss of motivation) and accecore flattening (a reduction in the range of
Discuss issues associated with the classification and/or diagnosis of schizophrenia
Discuss issues associated with the classification and/or diagnosis of schizophrenia One of the issue associated with the diagnosis and classification of schizophrenia is reliability.Reliability is how consistant a measurement is e.g the ICD and the DSM when diagnosis or classifiying schizophrenic patients.Reliability can be measured by inter rater reliability where they see if two independant sources come to the same diagnosis or classification or retest reliability where they see if the test used are consistant over time .Although psychologists say that DSM 3 is reliable , there is strong evidence that shows that reliability of the DSM is low when using inter-rater reliability.Whaley(2001) only found a small positive correlation between the different assesors.This is evidence of low reliability when using the DSM to diagnose schizophrenia ,however the test-retest reliability studies have shown more positive results which means that there is some sort of reliability with the DSM. Another issue surronding the diagnosis and classfication of schizophrenia is the cultral differences in diagnosis e.g A research study by Copeland et al (1971) compared 134 US psychiatrists and 194 British psychiatrists in their diagnosis of a patient, and found that 69% of the US psychiatrists diagnosed schizophrenia compared with only 2% of the British psychiatrists. This suggests that there is
Discuss issues surrounding the classification and diagnosis of schizophrenia
Discuss issues surrounding the classification and diagnosis of schizophrenia. The term reliability means that each time the classification systems are used (International Classification System for Diseases (ICD) and the Diagnostic and Statistical Manual of Mental disorders (DSM)) they should produce and provide the same outcome. The reliability of the early editions of these two classifications were marked as inconsistent and the vagueness of the DSM led to very low reliability in diagnosis. Schizophrenia was more commonly diagnosed in the USA (80% of patients during the 1950s) than compared to England (at the same period - 20%). However, ICD-10 and DSM-IV-TR have now become very similar, although there are two important differences between the classifications: the DSM requires symptoms to have been in evidence for a period of six months whilst ICD requires only one month. Secondly, the DSM is multi-axial, which means that various factors are taken into account before a diagnosis is made. Although most researchers agree that DSM-IV-TR has improved reliability; Eysenks argues that the approaches to diagnosing schizophrenia have proved to be reasonably reliable. However his argument is that the reliability of the DSM in everyday usage may be lower than seen in research studies - meaning that only research studies are recorded with high reliability and non-research studies
Discuss problems inherent to diagnosis and classification of abnormality
Discuss problems inherent to diagnosis and classification of abnormality This essay will be a critical evaluation of the diagnosis and classification of abnormality and the intrinsic problems involved. The term 'abnormality' is defined as 'deviation from a norm or standard', but how do psychologists determine what is abnormal or normal behaviour? The first attempt at classification of psychological abnormality was made by the Greek physician Hippocrates. He identified three categories, mania, melancholia and phrentis (fever of the brain). The first prevalent classification was developed by Kraeplin (1913) who collated earlier systems and elaborated on them. This then led to classification systems, different models and four definitions of abnormality being developed to define abnormal behaviour however, this is not an infallible system as discussed further on in the essay. Statistical infrequency is based on the idea that if certain behaviour, a person's personality or ways of thinking are statistically rare or unusual, then it is deemed as abnormal. They make no value judgements, for example homosexuality is no longer classed as wrong or unacceptable, just less statistically common. Nevertheless, the desirability of certain traits is not taken into account. If a person has a high IQ, they are deemed as 'abnormal', however, this should be classed as a gift not an abnormality.
