Issues with classification, diagnosis

ISSUE: GPs

• Not mental health specialists > fail to diagnose depression > untreated
•  If they knew there was a history of mood disorders > over-diagnosis> self-fulfilling prophecy > encourage the symptoms of depression
• Impact on employment,> diagnosis can impact the lives of the individuals, it is crucial to ensure that the diagnosis is valid.  

ISSUE: Tools used for diagnosed, DSM-IV and BDI

• Western-based diagnostic tools > influenced by western norms and values >symptoms may differ across cultures > non-western cultures often present more physical symptoms
• May only be appropriate to use in western cultures > culture bias > misdiagnosis of patients. 

ISSUE: Gender-bias in diagnosis

• Women are diagnosed twice as frequently as men > male sufferers may be less likely to disclose symptoms> diagnosis is influenced by expectations > male sufferers could be left untreated. 

ISSUE: Reliability of the tools used for diagnosis, DSM-IV and BDI

• Such tools should be consistently used amongst practitioners (inter-rater reliability) and also be consistent at different points in time (test-retest reliability).
• Keller et al. (1995). They were interviewed participants twice (6 months apart) using the DSM and found that test-retest reliability was poor-to fair, suggesting the DSM lacks reliability.
• Beck et al. (1996) found a significant correlation of .93 between two therapy sessions, one week apart, when the BDI was used, suggesting that tools such as the BDI are indeed reliable.
• Important to consider reliability, as if proven to be unreliable, people are either being diagnosed when they are not suffering…