Definition of "clinical depression" ?
Q.I am a little confused about the definition of "clinical depression". Based on my personal experiences it has to be either: 1. Fatigue the cause of which does not show up on a the following tests: Chem 20, CBC, thyroid panel, and sed rate. 2. The condition of having an MD say: "You are depressed".
A.Depression is a psychiatric (psychological) disease that is a syndrome of characteristic mental function alteration. Certainly these tests could be useful to diagnose a disease that might mimic depression, but absence of organic disease in the presence of fatigue is totally insufficient for a diagnosis. There are two sets of definitions depending on the convention you follow. US psychiatrists tend to use DSM-IV while UK psychiatrists prefer ICD-10. They are pretty similar but don't always overlap. See the ICD-10 and DSM-IV criteria in my other post. That is the formal criteria used by psychiatrists for diagnosis. The average GP and family doctor usually only uses the criteria loosely and makes a guesstimate of the diagnosis. Which is not to be poo-pooed, since a guestimate of a diagnosis is not necessarily better than a mathematically precise tabulation of a bunch of criteria which are themselves guesstimates and artistic judgements. There's nothing sacred about DSM IV. There's nothing even clinically predictive about it. Any anybody proven that people who tell you that they're really depressed and don't feel like living, are any less likely to shoot themselves or need to be hospitalized (or you pick the criterion) than people who meet the formal scoring conditions for DSM but refuse to admit they are depressed? I don't think so. Are you claiming that when an M.D. makes a diagnosis of depression that he/she is ALWAYS correct and that if the patient thinks that they are not depressed they are in denial? There are plenty of issues where a refined diagnosis predicts prognosis, probability of treatment success, etc. For example, paedophiles attracted to males are significantly less likely to benefit from treatment than paedophiles attracted to females. Making the distinction part of the diagnostic code is, to my knowledge, unique to DSM.
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