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Depression Misdiagnosed: How Internet Addiction Was Diagnosed as Depression? Determination and Understanding of Loss of Interest Symptoms

Time:2022-11-27 05:12:36 source:psychiatricethics.com author:Leisure vacation Read:187次
Depression Misdiagnosed: How Internet Addiction Was Diagnosed as Depression? Determination and Understanding of Loss of Interest Symptoms

This is a message sent by the parent of a child to the author: ask for help, Director LI, my son is depressed, and he was treated in our local tertiary hospital. I have been taking medicine for two months and it has no effect. I also say that life is meaningless. I often lose my temper and do nothing. I have dropped out of school for three months. Let it be said, let it go, if this goes on, the child will be ruined! What can I do? ? ? Please save the child! ! ! In subsequent communications, the authors discovered that the child had been misdiagnosed. Depression, especially in adolescents, is misdiagnosed and mistreated for a variety of reasons, the most critical being the following. 1. Diagnostic criteria for depression The symptoms of depression are as follows: 1. Loss of interest, no pleasure; 2. Decreased energy or fatigue; 3. Psychomotor retardation or agitation; 4. Low self-evaluation, self-blame, or Guilt; 5. Difficulty in association or decreased conscious thinking ability; 6. Repeated thoughts of death or suicidal or self-injurious behavior; 7. Sleep disturbance, such as insomnia, early awakening, or excessive sleep; 8. Reduced appetite or Significant weight loss; 9. Loss of libido. 2. Understanding of the symptoms of "loss of interest" The above nine criteria seem to be well understood by many people, and even many patients and their parents are already familiar with this criterion, but do they really understand it? What level did you understand? Know the diagnostic value behind the symptoms? For example, the symptom of "loss of interest" is often annotated in ordinary literature as "generally refers to the loss of interest in daily life, which is one of the symptoms of depression. The typical symptoms are depression, slow thinking, and reduced speech and movement." There have been many parents of patients who have asked the author for confirmation based on the diagnostic criteria they have found online or learned from some "professional" personnel. For example, this parent said: "Director LI, my son's symptoms all meet the diagnostic criteria for depression. , the doctor also diagnosed severe depression, how do you think it should be treated?" I asked, "Which criteria do they meet?" He said, "I lose interest and do nothing but play games and videos all day long. I lost my temper as soon as I ordered it." I asked, "Are playing games and watching videos also considered interesting?" The patient's parents were immediately confused. It's not just the patient's parents who are confused? ! Loss of interest is generally manifested in two situations: one is a decline in interest, which means that the types of interests are reduced, and the intensity of interest is reduced; the other is a basic loss of interest, and no longer interested in things that were originally interesting. Please note: Loss of interest is an important but not the only symptom in the diagnosis of depression. 3. Habit and Impulse Control Disorder In the above cases, after in-depth analysis, in addition to depression, the patient has a relatively strong interest in online games, online videos, violent pornographic films, mystery novels, romance literature, animation, etc. Occupying a dominant position in life, it is not only tolerated by society, but also harmful to oneself. This harm includes both physical harm and harm to social and psychological functions. According to the third edition of "Chinese Standards for the Diagnosis and Classification of Mental Disorders": Habit and impulse control disorder refers to a mental disorder that is driven by excessively strong desire to take certain inappropriate behaviors that are not allowed by social norms or cause harm to oneself. , the purpose of its behavior is only to obtain self-psychological satisfaction. For this patient, the first diagnosis should be: Habit and Impulse Control Disorder. 4. The relationship between depression and habit and impulse control disorder 1) Habit and impulse control disorder In the third edition of "Chinese Standards for the Diagnosis and Classification of Mental Disorders", only four are described. 1. Pathological gambling: The patient has uncontrollable gambling and strong interest, and has a sense of tension before gambling action and a sense of relaxation after action. The purpose of gambling is not to gain financial gain. 2. Pathological arson: The patient has a strong desire and interest in arson, and has a sense of tension before action and a sense of ease after action. Often think or imagine arson and the circumstances surrounding it. Arson is not for financial gain, retaliation or political purposes. 3. Pathological stealing: The patient has an uncontrollable desire to steal and a strong interest, and has a sense of tension before the act of stealing and a sense of relief after the act. The purpose of stealing is not for financial gain. 4. Trichotillomania (pathological hair plucking): The patient has a strong desire to pluck hair and put it into action, and has a sense of tension before action and a sense of relaxation after action. Attempts to control this action often fail, resulting in hair loss. This intention is not due to skin disease or other mental disorders such as delusions, hallucinations, etc. Although the patient in this case does not belong to the above four cases, but has the basic characteristics of habit and impulse control disorder and occupies a major position. According to the principle of "heaviness" in diagnosis, this diagnosis should be regarded as the first diagnosis. Note: Habit and impulse control disorders are often accompanied by depressive symptoms. However, having depressive symptoms does not mean that the patient is depressed. 2) Depressed state Although this case meets the symptom standard for the diagnosis of depression, it does not meet other relevant standards such as time standard and severity standard, so it is not suitable for making a diagnosis of depression. It is more in line with the state diagnosis of "depressed state". . The author of this case diagnosed: 1. Habit and impulse control disorder; (in vernacular is Internet addiction, author's note) 2. Depressed state. 5. Prognosis and effect of treatment Due to deviations in diagnosis, the effect of treatment is likely to be unsatisfactory, which is also a matter of course. Once the diagnosis is wrong, the treatment is bound to be "missed by a thousand miles". This case is basically ineffective for the treatment of the "top three hospitals", and it also verifies the diagnostic bias in disguise. Please note: Accurate diagnosis is very important. Many adolescents with depression are misdiagnosed and mistreated, so they are delayed or even lead to serious consequences. Diagnosis is more important than treatment, diagnosis has the attribute of strategic direction, and treatment has the attribute of tactical method. In order to achieve a better therapeutic effect, the two should not be neglected.

(责任编辑:Prevent anxiety)

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