Navigation Links
Study: Many physicians not using established criteria
Date:2/2/2010

  • Patients might not be accurately diagnosed
  • Patients who do not have major depressive disorder may be prescribed medications that will not work
  • Calls for a briefer definition of the DSM-IV criteria for MDD

PROVIDENCE, RI A new study led by Mark Zimmerman, MD, of Rhode Island Hospital indicates that a majority of non-psychiatrist physicians and a substantial minority of psychiatrists reported that they often do not use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) when diagnosing major depressive disorder (MDD) in patients. The study appears online ahead of print in the Journal of Clinical Psychiatry.

The criteria for MDD in DSM-IV have remained relatively unchanged for nearly 30 years. In a previous study, Zimmerman and colleagues questioned the clinical utility of the criteria. This study looks at the habits of physicians in using the criteria. The researchers asked physicians attending a continuing medical education conference to complete a brief questionnaire. A total of 291 physicians responded to the six questions, with one question asking about the use of the diagnostic criteria for depression.

The question read: "When diagnosing depression, how often do you determine whether the patients meet the DSM-IV diagnostic criteria for major depressive disorder?" A multiple choice response offered the following answers: a) less than 25% of the time; b) 26-50% of the time; c) 51-75% of the time and d) more than 75% of the time.

Nearly 25 percent of the psychiatrists indicated that they used the DSM-IV MDD criteria to diagnose depression less than half of the time. In contrast, more than two-thirds of the non-psychiatrist physicians indicated that they used the DSM-IV MDD criteria less than half of the time when diagnosing MDD. The difference between the psychiatrists' and the non-psychiatrists use of the criteria was significant.

Zimmerman, director of outpatient psychiatry at Rhode Island Hospital, says, "Our results suggest that a minority of psychiatrists and majority of non-psychiatrist physicians do not use the DSM-IV MDD criteria the majority of the time. These findings are disconcerting. While the symptom criteria for diagnosing MDD have not been changed much over the last 30 years, psychiatrists, especially older psychiatrists, apparently have not uniformly embraced their use and non-psychiatrist physicians seem to have rejected the formal application of the criteria."

Zimmerman, who is also an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, theorizes that doctors are not using the DSM-IV MDD criteria because of the length of the criteria, and some may not be able to recall all of the criteria. He says that if incomplete recall of the criteria is the reason it is not being used to diagnose MDD, then a shortened definition of MDD may help to facilitate appropriate application of the criteria across all practitioners.

The researchers suggest that if physicians are not determining whether the criteria for MDD are met, then it is possible that many patients who are diagnosed as depressed do not have major depression. This is of critical importance because there is little evidence that antidepressants are effective for patients who do not have major depression; thus, some patients may be prescribed medications unnecessarily.

Zimmerman found that the older psychiatrists reported that they were less likely to use the DSM-IV diagnostic criteria than younger psychiatrists. He offers the following as a possible explanation. "Perhaps older psychiatrists who were training in the pre-DSM-III era never bought into the importance of using operational criteria to make a diagnosis."

The researchers note that the study has limitations in that the reasons for not following DSM-IV guidelines were not asked, and interpretation of the question about the use of diagnostic criteria for MDD may not be consistent for all respondents. The results of the present study should be interpreted with caution because they did not conduct a random survey of psychiatrists and non-psychiatrist physicians practicing in the country and the physicians who did respond may not be representative of all physicians.


'/>"/>

Contact: Nancy Cawley Jean
njean@lifespan.org
Lifespan
Source:Eurekalert  

Related medicine news :

1. New Study: Innovative Technique Allows Male Cancer Survivors Who are Sterile from Treatment to Father Children
2. McGill-CHUM study: 56 percent of young adults in a new sexual relationship infected with HPV
3. IU study: Half of urban teen girls acquire STIs within 2 years of first sexual activity
4. New Study: Life Science Jobs Total 77,000 in Washington State
5. Study: Lap band surgery effective for morbidly obese children
6. Henry Ford Hospital study: A MRSA strain linked to high death rates
7. Science study: Teacher participation in Columbia program improves student achievement in science
8. Independent Study: OxiTitan VLR Antimicrobial Coating Kills Virus on Surfaces
9. Study: Raises and Turnover Lower in Tennessee and Florida Than National Averages
10. Study: The new buzz on detecting tinnitus
11. U-M study: Life and death during the Great Depression
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Study: Many physicians not using established criteria
(Date:2/11/2016)... ... February 11, 2016 , ... Talix today ... Practice , will be presenting at the 2016 HIMSS Annual Conference & Exhibition, ... , During his session, “ Coding for Care: Using Data Analytics for Risk ...
(Date:2/11/2016)... (PRWEB) , ... February 11, 2016 , ... Be ... new office in the heart of Old Town at 108 South Columbus St, Suite ... businesses the highest level of medical care in the convenience of their homes, offices ...
(Date:2/11/2016)... MA (PRWEB) , ... February 11, 2016 , ... The ... overpaying for IT services, what questions to ask your IT consultant before signing a ... access to your computer network. , “With companies relying heavily on e-mail and technology, ...
(Date:2/10/2016)... Los Angeles, CA (PRWEB) , ... February 10, ... ... Neuro-Linguistic Programming (NLP) practitioner, is known locally for a series of therapeutic sessions ... be in-the-moment in their characters and in their lives. The series, known as ...
(Date:2/10/2016)... (PRWEB) , ... February 10, 2016 , ... ... company is unveiling its revolutionary new 2.0 version at the International Roofing Expo ... “put the power of the world's most advanced weather technology in the hands ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)...  AcelRx Pharmaceuticals, Inc. (NASDAQ: ACRX ) today ... the 38th annual John A. Boswick , ... being held February 14-18, 2016 in Hawaii ... in wound healing, burn care, and infection control, and ... Burns Association, Academy of Physicians in Wound Care and ...
(Date:2/11/2016)... , Feb. 11, 2016  NanoViricides, Inc. ... it has entered into an agreement with the ... nanoviricides® drug candidates in standard animal models of ... , Research Director. Dr. Romanowski has extensive experience ... --> Eric Romanowski , Research ...
(Date:2/11/2016)... Israel , Feb. 11, 2016  Galmed Pharmaceuticals Ltd. ... company focused on the development of a once-daily, oral ... that its Chief Medical Officer, Dr. Maya Halpern ... Galmed as Chief Medical Officer and from its Board ... to her reaching retirement age. Allen Baharaff ...
Breaking Medicine Technology: