IS MAJOR DEPRESSION DISORDER OVERDIAGNOSED

Is Major Depression Disorder Overdiagnosed



Is Major Depression Disorder Overdiagnosed

About 121 million people are affected by depression worldwide, according to the World Health Organization, and rates of diagnosis have increased significantly in recent years. But are too many people now being diagnosed with depression? Gordon Parker, MB BS, MD, PhD, DSc, and Ian Hickie, MD, debated whether the diagnostic criteria for depression are too broad, leading to overdiagnosis in the general population, in editorials published in the August 18 BMJ and shared their opinions with NeuroPsychiatry Reviews.

Depression Is Overdiagnosed

Dr. Parker, Executive Director of the Black Dog Institute at the Prince of Wales Hospital in Sydney, believes that lowering the threshold for depression diagnosis risks leading to the treatment of normal emotional states as illness. “Everyone gets depressed,” Dr. Parker told NeuroPsychiatry Reviews, “and we can certainly destigmatize 'depression' as it ranges from the severe disease states even through to the normal mood states—by information and by suggesting appropriate strategies. The problem emerges if the overdiagnosis leads to inappropriate [treatment] or overtreatment.” Dr. Parker is also a Scientia Professor in the School of Psychiatry at the University of New South Wales in Sydney.

In the 1980 revision of its diagnostic manual, the DSM-III, the American Psychiatric Association exchanged a descriptive definition of depressive disorders for a criterion-based dimensional system, which categorized the disease into major and minor disorders, noted Dr. Parker. “Although its descriptive profile prioritized melancholic features (such as serious psychomotor disturbance or anergia), DSM-III's operational criteria were set 'at the lowest order of inference,'” he stated. A patient who reported dysphoric mood for two weeks—including feeling sad, blue, or down in the dumps—and experienced appetite change, sleep disturbance, drop in libido, and fatigue could now obtain medical insurance coverage for depression. Minor depressive disorder, ...