Does seeing a patient twice in four days meet any DSM criteria

[nz11]

Not one to start threads.

But i'd like to know an answer to this above title question.  So thought id go to the audience on this one.

Basically im in an argument with the med prof.

My understanding is for a diagnosis of depression to be made say the doctor has to see you over a 2 week period . That is the first criteria that must be met right? If not then such a conclusion is invalidated right.

 

A conclusion cannot be made from seeing a patient twice in 4 days right? And no criteria checklist even completed right?

Appreciate any replies on this.

[Junior]

I haven't heard that Mark.  I know that low mood has to be present for at least a 2 week period - together with anhedonia and other symptoms but I don't know about any requirement in the DSM for how often the Dr needs to see the patient before making a diagnosis.  TBH many doctors don't even 'diagnose' according to the criteria given.

[Ever]

Haven't heard of it Mark. When I was diagnosed (long long ago) it was just the one visit....

[WiggleIt]

I can't say from an accepted medical standpoint of how medicine is practiced.  However, as an academic researcher and former college professor (albeit in other fields), I would say that any conclusion made based only on a one- or two-time observation risks being a sloppy conclusion.

The whole medical field is excessively primitive, though.  The ******* doctors are just guessing at everything and we are their guinea pigs.  For example, you could have a case where one visit is enough to diagnose a sinus infection, based on fever and other symptoms present.  However, what about a complex case where a more serious illness is MIMICKING a sinus infection?  The second scenario requires more than one visit, but the time delay between visit one and visit two puts the patient at risk.  Because of that risk and because more serious diagnoses are considered rare, medicine now seems to be practiced in a way where doctors are pressured and rushed to make their diagnosis IMMEDIATELY.  What's worse, if we expect them to be more careful and take more time with their diagnosis, or if we question the diagnosis at all, they get resentful.

 

Your professor sounds like a moron, frankly.  He or she should at least be teaching students to consider MANY possibilities for diagnosis and to strive for the CORRECT diagnosis, not the fast one.  Obviously, for the safety of patients, diagnoses do need to be made as quickly as possible, but not at the expense of correctness.

 

Additionally, why would any doctor NOT use a criteria checklist?  A criteria checklist should be part of ANY diagnosis made of any medical condition, and I'm appalled to find out that's not how students are being taught.

 

Again, I'm no medical researcher, but I can tell you for a fact that this kind of sloppiness would never fly in my field, and I have no hope for the future of medicine or the safety of patients if this is how sloppily medical students are being taught.

Here is what the Mayo Clinic says about how the American Psychological Association diagnoses depression using DSM criteria (more than two weeks, by the way):

http://www.mayoclinic.org/diseases-conditions/depression/basics/tests-diagnosis/con-20032977 

 

Lastly, I think we should all be aware that even if someone DOES have symptoms for over a two-week period, that doesn't mean they suffer major depressive disorder or should be treated with drugs.  What if their child died tragically?  Or their mom, dad, or spouse?  What if they found out their significant other was having an affair?  For God's sake, ANY of those things could put someone into a lengthy depression, but still a temporary or manageable depression if it is a person with no history of mental health problems.  Life is HARD and everyone suffers at least one major depressive episode, but that does not mean that a depressive disorder diagnosis is accurate for every case of depression lasting for over two weeks.

 

NO WONDER people are being POISONED with unnecessary medications if this is how irresponsibly med profs are disseminating information. 

[nz11]

Thanks for the replies people.

Wiggleit im not referring to a professor im referring to the medical profession. ie doctors. Sorry for the confusion.But yes you are right they are just idiots. Yes i totally agree with what you are saying people are being pushed into druggery by uninformed consent for just stupid reasons ...they have as they say medicalized normality.

 

Junior thats right a 2 week period must exist within which specific symptoms  must exist. But to have a doctor just ignore it and do whatever...peddle drugs for whatever xyz reason is just unacceptable b/c how can they justify it. They are just making up defns. for petes sake . If not diagnosing on the criteria given then how does this stand up in court ...are doctors cowboys that can act with impunity and get away with it. Its disgraceful!

 

Ever thats terrible.!

 

Thanks for the replies.

[Junior]

Lord knows how it would stand up in court.  Interesting thought.  But then I understand that the DSM and even the ICD-10 or whatever edition we are up to are just 'guides'.  If I remember correctly, the DSM originally came into being to give some uniformity to the diagnoses psychiatrists were making.  People could go to 3 different psychs and get three different labels!

 

Personally I think the only ones who should be diagnosing and treating mental health conditions are those properly qualified to do so - clinical psychologists and psychiatrists - but then we all know what happens with the latter, don't we?  It's also astounding how psychiatry has moved from predominantly practising psychoanalysis to reducing people to biological objects.

[WiggleIt]

Ha!!!!  I totally assumed that "med prof" was short for a medical professor and that you were taking some kind of psychology class!

 

Well, THAT makes my former reply totally off the mark!  Oops!  I still stand by what I wrote, but a lot of might make more sense in a different context.