Conclusions

In this chapter, I have considered the practical difficulties facing the epidemiological study of depression. Epidemiology is a medical approach that relies initially on the conceptualization of impaired functions as disorders, followed by a requirement to identify these disorders in a reliable way. Depression as conceived shades both into normal experience and into other affective disorders. Distinguishing it in a way at once useful and consistent is thus difficult, as I have argued in some detail. In particular, the comparability of studies is jeopardized by differences between classifications and instruments and in the way these are applied. The consequence is that no two research teams are likely to identify the same sets of respondents as cases; indeed, in practice, the overlap is small, and there may be systematic over- or under-identification, resulting in different prevalence rates. I now think these obstacles to precise case identification are probably insuperable. Nevertheless, the arguments remain strong for doing the best we can. Two things alleviate this rather miserable conclusion. Because most cases identified in general populations are around the threshold that distinguishes them from non-cases, different studies are likely to end up with case groups that have similar characteristics. Robust associations—for example, the association of depression with life events or with poverty—will therefore survive the inadequacies of our instrumentation.

The second way around these inadequacies is to supplement the medical case approach with studies that look at the correlates of total symptom score. In this way, important findings can be triangulated, as they are in the study of blood pressure.

Letting Go, Moving On

Letting Go, Moving On

Learning About Letting Go, Moving On Can Have Amazing Benefits For Your Life And Success! Don't be held back by the past - face your guilt and fears and move on! Letting go is merely arriving at a decision, no more allowing something from the past tense to influence your life today or to cut down your inner sense of peace and welfare.

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