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

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

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