mediate rate for major depression (17%) with relatively
high impairment (85%) and misses only 15% of
impaired patients diagnosed with the inclusive approach.
A recent study that examined reliability of
judgments made by clinicians in determining the origin
of depressive symptoms showed that mental health
professionals can be trained to reliably determine the
etiology of depressive symptoms (as required by the
etiologic approach) (15). Nevertheless, even the etiologic
approach still misses a considerable number of
patients with significant depression, thus improving
specificity at the cost of sensitivity and at the cost of
some reliability.