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Psychiatry's main method to prevent mistaken diagnoses of depression doesn't work: NYU study
Date:2/24/2010

iatry. The article argued that there were indeed large numbers of false-positive diagnoses of major depression in community surveys of mental disorderpossibly as high as 25% to 33%. However, that study used data from a national survey that was conducted before the DSM-IV's addition of the CSC to the major depression diagnostic criteria. Thus, there was no CSC in the criteria that Wakefield and his team used to identify cases of major depression at the time. Critics of that study argued that the lack of a CSC was fatal to the argument because if the CSC had been used, then the supposed false-positive diagnoses that Wakefield and his group identified would likely have been eliminated as cases too mild for diagnosis. For example, one noted psychiatrist argued that Wakefield's results were due to a "glitch" in the diagnostic criteria Wakefield used, and that the diagnosed individuals identified by Wakefield as having normal reactions would have been eliminated from the depression category if current diagnostic criteria including the CSC were used. A paper later submitted by Wakefield that built on the 2007 article was rejected for publication partly based on a reviewer's assertion that if the CSC had been included in the earlier study, the supposed false positives likely would have been eliminated. So, the issue of whether the CSC is in fact redundant or actually eliminated many false-positive major depression diagnoses became key to the debate, which is still ongoing, about the prevalence of depressive disorder.

The latest study, coming in the American Journal of Psychiatry, offers an empirical demonstration, based on nationally representative data, that the Critical Significance Criterion fails to distinguish normal from disordered conditions. In this analysis, Wakefield undertook to evaluate independently the impact of the CSC on epidemiological survey estimates of major depressive disorder by using data from a later survey that included a carefully
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Contact: robert polner
robert.polner@nyu.edu
212-998-2337
New York University
Source:Eurekalert

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