Doctor claims depression over-diagnosed
Friday, 17 Aug 2007 09:45
Depression affects one in four people at some point in their lives
Too many people are being diagnosed with depression when they are suffering from normal human distress, a doctor has claimed.
This is making the condition less credible as the term is sometimes being used for people who are not seriously clinically depressed.
Professor Gordon Parker, a psychiatrist from the University of New South Wales, argues in this week's British Medical Journal (BMJ) that the current threshold for what is considered to be clinical depression is too low.
He believes "it is normal to feel depressed", partly basing this assumption on a study of 242 teachers.
When depression was defined as "a significant lowering of mood, with or without feelings of guilt, hopelessness and helplessness, or a drop in one's self-esteem or self-regard", over 90 per cent of the teachers reported such feelings.
According to Professor Parker, the over-diagnosis of clinical depression is due to the change in its categorisation in 1980, which split it into major and minor disorders.
The simplicity and gravitas of major depression gave it a cachet among clinicians, he argues, while the descriptive profile set a low profile including feeling "sad, blue…down in the dumps".
Problems with categorisation mean doctors risk medicalising normal human distress and viewing any expression of depression as necessary of treatment.
"Depression will remain a non-specific 'catch all' diagnosis until common sense prevails," he concludes.
In response Ian Hickie executive director, Brain and Mind Research Institute, University of Sydney, said that studies carried out in the UK, Australia and New Zealand do not support the notion that the condition is over-diagnosed.
He adds that increased diagnosis has led to a reduction in suicides and the stigma of being depressed.
"We have at last abandoned the demeaning labels of stress, nervous breakdown, and adolescent angst," he writes in the BMJ.
"Most doctors can now differentiate normal sadness and distress from more severe clinical conditions."