MAJOR DEPRESSIVE DISORDER RESEARCH THROUGH THE COGNITIVE PSYCHOLOGY APPROACH Essay Example

MAJOR DEPRESSIVE DISORDER RESEARCH THROUGH THE COGNITIVE PSYCHOLOGY APPROACH Essay Major Depressive Disorder Research through the Cognitive Psychology Approach Name: Course: Date: We will write a custom essay sample on MAJOR DEPRESSIVE DISORDER RESEARCH THROUGH THE COGNITIVE PSYCHOLOGY APPROACH specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on MAJOR DEPRESSIVE DISORDER RESEARCH THROUGH THE COGNITIVE PSYCHOLOGY APPROACH specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on MAJOR DEPRESSIVE DISORDER RESEARCH THROUGH THE COGNITIVE PSYCHOLOGY APPROACH specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Major Depressive Disorder Research through the Cognitive Psychology Approach Introduction Major depressive disorder affects millions of people worldwide every year and has become a common clinical condition. Normally, a person suffering from this disorder normally exhibits a sad mood and disinterest in things that would previously have fascinated him or her. Depression primarily has an effect over the â€Å"whole body†. In this case, the patients’ emotions and behavior undergo immense alteration. The exact causes of this condition are hard to pin point with some believing that it is hereditary or may be caused by an imbalance of chemicals in the brain. It has been established that major depressive disorder is a common condition among people suffering from Parkinson’s disease (PD) as well as a major contributor to disability and poor life quality (Nilsson, Kessing, Sorensen, Andersen, Bolwig, 2002). However, it is important to realize the difficulty of assessing this condition in patients with PD because of overlapping symptoms and assessing it in patients with cognitive impairment. In this regard, the Movement Disorder Society endeavored to carry out a research over the assessment of depression among patients with PD. A number of rating scales are used for the assessment of depression. The research was hence carried out to ascertain their credibility and consequently make recommendations. Literature Review Symptoms of depression have a tendency of occurring in people suffering from PD with studies suggesting that 40 percent are usually affected. Symptoms of depression have been recognized as being main determinants of how healthy PD patient lives and can as well affect cognitive function, and functional ability. This therefore makes it essential for the recognition and assessment of symptoms in patients suffering from PD. The research was able to identify a number of rating scales for the assessment and screening of depression disorder. Apparently, these scales are used to assess depression among patients suffering from PD or not (Hahlweg Goldstein, 2007). For purposes of selecting the scales, the research included all scales used for the assessment of depression disorder and those with the potential utility of assessing depressed patients suffering from PD. Scales specifically designed for the assessment of conditions similar to depression such as anxiety, apathy, and anhedonia were excluded. At present, the diagnosis of depressive disorder is done through the diagnostic and statistics strategy (DSM-IV) as recommended by the American Psychiatric Association. However, contrary to what the research found on the diagnosis of depressive disorder, I was able to establish otherwise. In this case, in research studies and clinical practice, particularly in treatment trials and surveys measuring the symptoms of depressive disorder, the use of DSM-IV is often not useful or feasible. The use of DSM-IV has shortfalls and has been recommended to undergo for revision. Even though discussions over how valid this criteria for depression assessment were not at the scope of the research, the problems involved and how they influence the assessment of severity and presence of depression in PD patients needs to be recognized and discussed. Methods The research team endeavored to form a committee for investigating the credibility of depression rating scales for patients with PD. The committee included seven members from North America, Europe, and Australia and included psychiatrists, psychologists, and neurologists who had good records of accomplishment in the field of depression for patients with PD. The members of the task force identified problems affecting the assessment of major depressive disorder. The team also identified eligible scales to be investigated. In this regard, I think that the committee members should have been subjected to a survey or interview to verify their credibility within the depressive disorder field. This would have been an efficient way of ensuring that the team selected was qualified to execute the research task. Nevertheless, the committee members organized a survey on the types of scales used to assess depressive disorder. The response rate amounted to four percent with 79 out of 2000 neurologists returning their questionnaires. A poor turn out of responses in this case possibly means that few neurologists make routine use of depression scales. In this regard, since the results of the research were drawn from a limited resource, then that ultimately renders the findings partly inconclusive. However, the research committee endeavored to formulate proforma for allowing a structured assessment of the depression scales. The proforma showed descriptions over scale availability, content, acceptability, and use. Judging by this data collection method, the committee worked well with the little information source they received and made clear and detailed tabulations. All statements made from the information were referenced and quantitative and qualitative results were summarized and tabulated. The rest of the task force assessed completed reviews and modified them in tune with unanimous suggestions. The chairperson was responsible for summarizing the identified problems, reviews, and conclusions. The final report was modified following group discussions with the entire task force. Results DSM-IV defines major depressive disorder as a loss in pleasure or interest or depressed mood for a period not less than two weeks, together with other symptoms that represent change from previous psychological state. These other features are changes in weight or appetite, retardation, insomnia, slowed speech, thought, worthlessness feelings, fatigue, guilt, death or ideas of suicide. Fundamentally, there should exclusion of symptoms that suggest a general condition. From this finding, I was able to establish that rating some of the depression symptoms is a daunting task because of considerable overlap of depression symptoms and PD symptoms. However, it is not clear whether there should have been an adoption of an inclusive approach for rating scales. The decision concerning how the symptoms should be rated is not trivial and influences the results of the study. In this regard, using diagnostic criteria and scales that have automatic inclusion of all somatic symptoms is capable of leading to incorrect depression results. In this situation, patients are more likely to be diagnosed with depression without the core depression symptoms. Alternatively, scales that do not include these symptoms may exhibit poor validity of criteria, particularly at as the depression spectrum ends. For example, apathy is a cardinal symptom of depressive disorder. However, apathy also occurs independently without depression (Nilsson, Kessing, Sorensen, Andersen, Bolwig, 2002). The research was also able to establish that major depression in some aspects differs from depression in PD. Furthermore, most of the patients suffering from PD exhibit depressive symptoms that do not fulfill the conditions of a major depressive episode. The research was also able to establish that scales for assessing depression have different uses. For example, one purpose serves to assess how severe depression is and check how the patient responds to antidepressant treatments. For this research or clinical task, a scale’s reliability, responsiveness, and responsiveness to good changes is relevant. The other reason of using rating scales is screening patients with PD for the possibility of depression. For purposes of screening, each use has use has an importance in clinical settings that require self-rating scales or untrained raters. Scales with good specificity and sensitivity may be used as screening tools. Rating scales used in depression do not offer assessment timing, something that is particularly crucial in patients suffering from PD. Furthermore, majority of rating scales are clinician rated, or patient reported. In this case, inputting collateral information may prove beneficial when assessing patients with PD. However, how or whether to use such information needs to be operationalized. The research found nine scales for assessing depression for patients with PD. These include the beck depression inventory, the Hamilton depression scale, the Zung depression scale, the Geriatric depression scale, the Montgomery depression scale, and the hospital anxiety and depression scale. Additionally, the corner scale was incorporated because it is the only universal scale used for patients with cognitive impairment, a common condition among depression patients with PD (American Psychiatric Association, 2000). Some scales were not included but were considered because they only assess moods wit h short life such as Profile Mood States. Whilst the results were in recognition of the limitations of the DSM-IV diagnostic criteria and recommendations for criteria improvement, these DSM-IV criteria should have been used for purposes of measuring the validity of the criteria in the literature. All scales were established as valid even though structure was subject to variance thus leading to chances of differentiation of the results. There was no available data to suggest the one responsible for administering observer rated scales. However, information regarding the training need on each scale should have been provided. Discussion All scales reviewed in this research have some relevance in their purpose of assessing depressive disorder. Available scales for depression have a number of functions. Different purposes mean that different properties of the scales have to be taken into account. Recommendations should be made regarding how appropriate each scale should be used. Diagnosing depression should not solely be made based on a rating scale score. A mere score of these instruments cannot capture a comprehensive range of depression disorder. In this case, high scores may arise when the endorsement of somatic symptoms occurs (Sudak, 2012). On the other hand, low scores may occur even though serious symptoms of depression are present. For this reason, the standard for diagnosing depression has to remain the DSM-IV criteria. Limited evidence is enough to warrant the best scales for rating depression for patients with PD. The statistics from the research suggest that other scales may be useful. However, further studies need to be conducted. Patients are sometimes capable of perceiving their condition in an off rather than an on period. Off periods can be linked with psychiatric symptoms such as delusions, anxiety, and depression. These often improve with time since they are short lived. Since the reviewed scales have been made to make correct assessments, the preceding one or two weeks the off periods may not be considered. The recommendation in this case requires that patients exhibiting motor fluctuations to be assessed while they are in the on period. More studies need to be undertaken on the specificity, sensitivity, and negative and positive predictive values for every scale. Assessing the concurrent credibility of the scales should be made in comparison to the criteria for DSM-IV of major depression. The criteria of assessment of depressive condition are going through changes (Guay, 2012). Incorporating somatic symptoms in depression scales leads to incorrect scores for patients suffering from PD. This may therefore influence the outcome of treatment trials. This calls for an investigation in a clinical format. In general, the observer should use an inclusive approach when scoring answers and patients have to be informed that they should not attribute their symptoms to depression or PD when scoring scales of self-rating. The instruments evaluated in this research are not used to or were not designed to identify subsyndromal or minor depression, and do not offer reflections over the diversity PD mood disorders have. Thus, there is a need to make further characterization of other depressive disorder types. Furthermore, cutoffs need to make adopted for the purpose of research and a specified period designed to include a larger variety of depressive disorders rather than dealing with major depression through cutoffs. Furthermore, there is a need for separate assessment when using scales to measure anhedonia, anxiety of apathy. In this research, the team did not make an assessment on multidimensional scales. However, these scales may prove useful in certain circumstances and have to be validated prior to their recommendation for usage. The caregiver’s role in reporting depression symptoms needs to be operationalized and in particular with scales that assess depressive disorder with comorbid symptoms. Whilst assessing depressive disorder with patients suffering from PD, the task force committee agreed that a majority of the same setbacks would be encountered when a new scale for PD is being developed. At present therefore, the task force does not offer any recommendation for a new scale development. Rather, it advises better studying existing scales. Developing a depression scale in PD is feasible and relevant only when there is an agreement over certain conceptual issues. Furthermore, the aspect of comparing symptoms of depression in PD with those from psychiatric disorders bears advantages. In conclusion, it is vital to recognize that major depressive disorder is a widespread mental complication in the modern world that may sometimes lead to disability or disease such as Parkinson’s disease (PD). The Movement Disorder Society in the United States endeavored to carry out a research in order to assess depressive disorder among patients with PD. The research was able to identify a number of rating scales for the assessment and screening of depression disorder. In this regard, these scales are used to assess depression among patients suffering from PD or not. The research was able to establish that the diagnosis of depressive disorder is at present being carried out through the diagnostic and statistics strategy (DSM-IV). This is as recommended by the American Psychiatric Association. However, upon reviewing the findings of this research, it is vital to recognize that certain considerations need to be appreciated. In this case, I was able to establish that the diagnosis of depressive disorder should not solely be made based on a rating scale score. A mere score of these instruments cannot capture a comprehensive range of depression disorder. This implies that further tests need to be made carried to facilitate informed and correct conclusions regarding the psychological status of the patient in question (Puig Encinas, 2012). Reference American Psychiatric Association. (2000). Practice guideline for the treatment of patients with major depressive disorder. Washington, D.C: American Psychiatric Association. Brown, M. R. (2004). Major Depressive Disorder Research. New York: Nova Biomedical Books. Guay, A. (2012). Major depressive disorder. Delhi: Research World. Hahlweg, K., Goldstein, M. J. (2007). Understanding major mental disorder: The contribution of family interaction research. New York: Family Process Press. Nilsson, F. M., Kessing, L. V., Sorensen, T. M., Andersen, P. K., Bolwig, T. G. (2002). Major depressive disorder in Parkinson’s disease: a register-based study. Acta Psychiatrica Scandinavica, 106, 3, 202-11. Puig, F. J. E., Encinas, F. J. L. (2012). Effectiveness of Cognitive-Behavioral Treatment for Major Depressive Disorder in a University Psychology Clinic. The Spanish Journal of Psychology, 15.( 3). 1388-1399. doi: http://dx.doi.org/10.5209/rev_SJOP.2012.v15.n3.39423 Simpson, H. B. (2010). Anxiety disorders: Theory, research, and clinical perspectives. Cambridge: Cambridge University Press. Sudak, D. M. (2011). Combining CBT and medication: An evidence-based approach. Hoboken: Wiley.