Anxiety and Depression - Essay Example

Critical Appraisal This journal is an attempt by the to chronicle the events related with depression, its causation, its natural history, and its predisposing factors. However they have failed to give any new information to the authors; though the journal is well written, well researched, extensive statistical analysis has been performed, and the data reasonably well presented, but there are a number of important features that have either not been evaluated or not been studied. These factors will be evaluated in the following sectionsThe authors have set out to discuss the importance of factors like co-morbid depression, and cognitive impairment, physical illness, life events, social factors, personal and family history of psychiatric illnesss, and drug treatment, and evaluated these using the modified GMS-AGECAT.

Thought the methodology of evaluation and the subsequent analysis are fairly standard, there are a number of discrepancies noted. The authors are not exposed to the events leading to depression of the initial cohort, and whether it was of mild or severe nature. Whether the phase was preceded by same family or economic disaster, or were the patients genetically prone to the illness is not laid out. When present status of the cohort is discussed, the article does not mention1 How many of the patients had family support It does not require studies to know that anybody who has a strong family support has a greater capacity to withstand trauma than one without2 How were the previous cohort rehabilitated If the cause of the previous depression was an acute temporary event, the individual has a greater chance to come out and carry on with life.

The authors needed to correlate the present incidence of depression with the causative factor initially3 The authors have given an incidence of 30% mortality in these individuals. It is probably more important to actually discuss the cause of the mortality also. We do not know the ages of the patients, and the exact etiology. The causation of death can be natural in some percentage, and how many of the dead were actually suffering from persistent depression only can point this to be the cause.

The questionnaire has not been included in the journal. So it is very difficult to correlate the investigations with the analysis. But is does appear that the laid out objectives of the authors have been answered by the above study. For example the authors have nicely brought forward the role of family history, finding it to be of significance in the etiology. The fact that proper medications have a major role in further therapy and prognosis is also a factor well highlighted by the authors. But these are points which are known, and do not need investigations.

Proper medicines and regular treatment are a must to treat any chronic illness, like seizure activity, which can relapse if treatment is not proper.The authors have failed to give concrete recommendations following their results, for example they mention the failure of physicians in diagnosis of anxiety and depression, but do not lay down any diagnostic protocols. They have not mentioned the role of social security system, need for a strong family network, role of police in allying any fears to life from antisocial elements.

Thus the authors do not send across any meaningful message for readers of the journal. In summary, the authors have been effective in enumerating the number of different predisposing factors in depression, the list quoted seems reasonably exhaustive, the methodology is effective in analyzing the factors that they have set out to analyze, and the technique does appear fullproof, as it is an established procedure. However there are a number of shortcomings as the authors fail to provide food for thought to the reader.