Download MOCK- A grade depression essay

3) One issue relating to the classification of depression is reliability. One form of reliability is interrater reliability (the extent to which two or more diagnosticians would classify the same patient with
the same diagnosis). Beck’s study demonstrates this issue as he looked at inter-rater reliability
between two psychiatrists when examining 154 patients and found that inter-rater reliability was
54% in that only 54% of the time diagnosticians diagnosed the same person with the same disorder.
This shows the lack of reliability present in diagnosing patients. This may means that some patients
may receive an incorrect diagnosis, leading to an incorrect treatment, thus not relieving symptoms
of their disorder.
4) One biological therapy for depression I the use of drugs. There are various different types of drugs
that work in different ways. One drug is selective serotonin reuptake inhibitors (SSRIs) that work by
blocking the reuptake of serotonin in the synaptic cleft to increase the levels of serotonin available,
which is thought to alleviate symptoms of depression such as lack of motivation. Tricyclic’s (TCAs)
work in a similar way by blocking the reuptake of noradrenaline and serotonin in the synaptic cleft,
again increasing levels of neurotransmitters present in the synaptic gap, as the biological theory
argues that neurotransmitters play and important role in depression. Another biological therapy is
electroconvulsive therapy (ECT). This involves passing 70-130 volts of electricity through the nondominant hemisphere for 1-5 seconds, inducing a seizure, which is believed to be the therapeutic
part of the therapy. It is unknown how this therapy works, unlike drug therapy, and is only
administered to severely depressed people who are resistant to treatment, whereas drug
treatments is one of the most commonly used therapies for depression.
For both ECT and drugs there is a debate as to whether they truly work, or whether it is simply a
placebo effect. However, Arroll et al found both TCAs and SSRIs were shown to produce a more
significant reduction in depression symptoms in comparison to a placebo, demonstrating the
superiority of drugs to a placebo. In addition, Gregory et al found that when real ECT was compared
to a sham ECT there was a significant difference in results; the real ECT was a lot more effective than
the fake ECT, showing its superior to the placebo.
Additionally, there is a debate as to whether drugs and ECT are a long term solution to depression as
they only treat symptoms of depression, such as low mood, rather than the root cause of depression
like cognitive-behavioural therapy. Deniblis et al. (2005) compared depressed people on SSRIs and
depressed people receiving cognitive treatments and found in both of the groups 58% of people
showed a reduction in symptoms. Hollan continued to follows this study and found that those
received cognitive treatments only 31% relapsed, those who received drug treatment only 47%
relapsed and those who received drug treatment and stopped 70% relapsed. This demonstrates that
drug treatment is not a suitable long term solution as a large proportion of people relapse (start
showing symptoms of depression again) once drug treatment is stopped, whereas very few of those
receiving cognitive treatments relapse, suggesting cognitive treatments are a superior treatment to
drug therapy as it appears to be a long term solution whereas drugs aren’t, as if the root cause isn’t
eliminated It may always reoccur.
In the debate of ECT versus drugs to finding a superior treatment, Scott reviewed studies comparing
ECT with antidepressants and found ECT is more effective as a short term treatment of depression.
This demonstrates that is it not appropriate as a long term treatment of depression, even less so
than drugs.
Furthermore, with biological therapies there are serious side effects such as an increased risk of
suicide. Barbuiet et al found that SSRIs increased the risk of suicide in teenagers (this effect wasn’t
found in adults), thus biological therapies are not appropriate for all people, whereas other
treatments such as cognitive therapies are suitable for all. This means that biological therapies may
be viewed as a ‘weaker’ therapy as it comes with many dangerous side effects than other therapies
that are just as effective don’t come with.
However, there is an argument that there is a publication bias present in biological therapies
(especially drugs) as drugs are cheaper, quicker and easier than cognitive treatments. This may be
favoured by doctors because waiting lists are long and quick treatments are often needed, thus they
may be used more.
Also, there are no trials comparing ECT with newer types of antidepressants, such as SSRIs, so these
studies may not be temporally valid in that these findings don’t apply to modern day drugs.
AO1 – 4/4
AO2/3 – 12/16
Total – 16/20