Measurement of Depression
The coexistence of many measurement scales reflects the divergence of conceptual approaches to depression and the fact that depression is a syndrome rather than a single entity. No one symptom is diagnostic for depression, and different people will exhibit widely different symptoms. These are generally grouped into affective (crying, sadness, apathy), cognitive (thoughts of hopelessness, helplessness, suicide, worthlessness, guilt), and somatic (sleep disturbance, change in energy level, appetite, sleep, elimination) (18; 19). Not all are present in every case. Hence, measurements must cover several dimensions, and it is the choice of coverage that distinguishes most rival scales. These differences in content in turn reflect underlying differences—for example, in the etiological theory of depression that different measures represent (e.g., biological versus psychodynamic)— or differences in the response system monitored (e.g., cognitive behavioral, physiologic, or affective) (20). Depression measurements are divided into two major groups: self-rating methods and clinician-rating scales, which correspond roughly to their use in clinical versus epidemiological studies. The basic approach is the clinical rating, with self-ratings offering a less costly alternative. A formal diagnosis of depression requires the exclusion of other explanations for the symptoms, and this requires a clinical examination. The DSM-IV, for example, requires the exclusion of possible explanations such as the physiological effects of drugs or medications and medical conditions such as hypothyroidism or schizophrenia. Because this requires a clinical assessment, it is widely accepted that self-assessed measures of depression can identify the syndrome of depression but, as with dementia, cannot be regarded as diagnostic devices.
ประเมินโรคซึมเศร้า The coexistence of many measurement scales reflects the divergence of conceptual approaches to depression and the fact that depression is a syndrome rather than a single entity. No one symptom is diagnostic for depression, and different people will exhibit widely different symptoms. These are generally grouped into affective (crying, sadness, apathy), cognitive (thoughts of hopelessness, helplessness, suicide, worthlessness, guilt), and somatic (sleep disturbance, change in energy level, appetite, sleep, elimination) (18; 19). Not all are present in every case. Hence, measurements must cover several dimensions, and it is the choice of coverage that distinguishes most rival scales. These differences in content in turn reflect underlying differences—for example, in the etiological theory of depression that different measures represent (e.g., biological versus psychodynamic)— or differences in the response system monitored (e.g., cognitive behavioral, physiologic, or affective) (20). Depression measurements are divided into two major groups: self-rating methods and clinician-rating scales, which correspond roughly to their use in clinical versus epidemiological studies. The basic approach is the clinical rating, with self-ratings offering a less costly alternative. A formal diagnosis of depression requires the exclusion of other explanations for the symptoms, and this requires a clinical examination. The DSM-IV, for example, requires the exclusion of possible explanations such as the physiological effects of drugs or medications and medical conditions such as hypothyroidism or schizophrenia. Because this requires a clinical assessment, it is widely accepted that self-assessed measures of depression can identify the syndrome of depression but, as with dementia, cannot be regarded as diagnostic devices.
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