Diagnosis of major depression in cancer patients according to four sets of criteria

Article Abstract:

There are several available tools for diagnosing psychiatric disorders in patients, the most commonly used being the DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised) and the Research Diagnostic Criteria (RDC). However, these two diagnostic tools do not always agree, or render consistent results. This study was done to find correlations among depression diagnoses made according to the DSM-III-R and the RDC, and two commonly used self- and observer-rated depression scales, the Beck Depression Inventory and the Hamilton Rating Scale for Depression, in cancer patients who had potentially fatal solid tumors. One hundred fifty-two patients were identified who reported symptoms of depression by the Beck and Hamilton depression scales. These patients were given a screening questionnaire for depression according to the DSM-III-R and RDC criteria, which exclude the diagnosis of major depression if symptoms are thought to be related to a physical condition. Since four out of nine criteria for major depression in the DSM-III-R are body-related (somatic), deleting these automatically because there is a medical condition makes the diagnosis of depression in cancer patients much more difficult to achieve. The depression symptoms of these patients were recorded regardless of whether the suspected cause was medical or psychological. Approximately one-third of these patients met the criteria for major depression by at least one set of criteria. The Beck and Hamilton scales could only differentiate patients with major depression and those with depressive symptoms at higher score levels. It is clear that there is inconsistency and overlap in the diagnostic tools available, but further study is needed to assess if one of these classification systems is most appropriate for diagnosing major depression in patients with medical illness. At this point they should be used to screen those at risk for depression, rather than to make definitive diagnoses. It is suggested that future scales use only psychological symptoms as criteria when diagnosing mental illness in this type of physically ill patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Cancer, Cancer patients, Psychiatric rating scales, Psychiatric status rating scales

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Patterns of depressive symptoms in expectant and new parents

Article Abstract:

Past studies to assess the distressful effects that the birth of a new child can have upon the parents have primarily concentrated on the mother and the father separately. It is hypothesized that similar patterns of distress might occur between couples during late pregnancy and shortly after the birth of the child. It is also surmised that having a spouse with symptoms of depression would increase the risk for the other spouse. To test these hypotheses, 86 couples out of 106 healthy adult couples who were experiencing a first pregnancy completed a study that assessed depressive symptoms. The Center for Epidemiologic Studies Depression Scale was used to evaluate symptoms in the 34th week of pregnancy and eight weeks after the child was born. No depression was found in 50 of the couples; in 32 of the couples one spouse was depressed; and in four couples both spouses had symptoms of depression. Almost three fifths of the couples had at least one member with depressive symptoms just after the birth of the child or late in pregnancy. An unexpected pattern was detected in which if one spouse became dysphoric, the other spouse was not likely to be symptomatic. One positive consequence may be that a child is unlikely to have two depressed parents at the same time. However, the implications of these results are not fully understood. It is believed that the incidence of psychological distress associated with the postpartum period and the late stages of pregnancy have been underestimated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Parenthood, Childbirth, Delivery (Childbirth)

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The DST in children and adolescents with major depressive disorder

Article Abstract:

The dexamethasone suppression test (DST) is used to diagnose depression. This review analyzed results from 13 prospective studies on the use of the DST in children and adolescents with psychiatric disorders. Affected children had a higher sensitivity to the test than affected adolescents (69.6 percent and 47.1 percent, respectively). Many more adolescents with major depressive disorder than with other psychiatric diagnoses, especially conduct disorder, were unable to suppress production of cortisone following a controlled dose of dexamethasone. The authors discuss the potential usefulness of the DST in distinguishing between major depressive disorder and conduct disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Dexamethasone, Depression in children, Childhood depression, Neuroses

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