The purpose of this paper is to summarize and critical evaluate the following article on the diagnostic difficulties associated with the development of depression following an accident:
Rabasca, L. & staff. (1998). When a patient is depressed after an accident, it is often difficult to determine what is causing depressive symptoms. APA Monitor, 29(11): Document available at: www.apa.org/monitor/depress.html.
This article is not an empirical study but rather a description and discussion of those factors and variables that make proper diagnosis of the etiology of the depression following an accident difficult. Following the discussion of factors contributing to diagnostic problems, several recommendations are made to psychologists for working with patients who develop depression following an accident.
The article begins by noting that depression following an accident could be: (a) a psychoemotional reaction to the accident; (b) a reaction to the symptoms (e.g., impaired brain injury, difficulty concentrating, fatigue, headache, dizziness, impaired judgement, etc.) associated with Mild Traumatic Brain Injury (MTBI); or (c) both a reaction to symptoms and a general psychoemotional response to being in an accident.
It is then noted that not only is it difficult to determine the proper diagnosis for a patient with depression following an accident but also that misdiagnosis is quite common. Several reasons are provided for the high frequency of misdiagnosis. These are said to be:
1. The patient with mild traumatic brain injury does not appear different from the patient with simple depression due to the subjectivity of the symptoms associated with both disorders.
2. Mild traumatic brain injury can often occur as a result of even minor accidents in which the patient's head never came into contact with an object. This makes it difficult to spot the fact that a head injury has occurred.
3. Mild traumatic brain injury ...