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PICO Analysis of Depression Coursework

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Updated: Jun 6th, 2022

Introduction

Depression is a mood disorder, that is, a complex of mental disorders associated primarily with the emotional sphere. By applying PICO (patient, intervention, comparison, outcome) as a tool to analyze the underlying issue, it is possible to understand the full scope of the problem. The given methodological tool allows an analyst to conduct a systematic and structural review of the current data on a particular issue, such as depression. In addition, depression can be characterized by certain disorders in the field of thinking. People with the given disorder are more prone to suffer a severe form of depression and find it difficult to concentrate and carry out a targeted mental activity, which is associated with concentration. Thus, cases of depression can be prevalent among older adults, non-Western cultures, and people with cardiovascular diseases.

Pico Analyses of Research Topic

Depression has such physiological manifestations as sleep disturbances and intestinal functions. In patients with depression, the general energy level is disturbed, and they feel tired. Intervention is depression somatization and it occurs when a person experiences high discomfort in the body. In comparison with other mental disorders, a person’s behavior can show a serious passivity, where he or she attempts to avoid contact with people with refusal from entertainment. The outcome is that depression is often accompanied by increasing abuse of alcohol or other psychoactive substances that are used to improve mood. The main question is how depression is formed and developed, and what are the primary triggers. Therefore, the question is: in older adults, non-Western cultures, and people with cardiovascular diseases (P), how depression screening and detection methodologies (I) compared to conventional scoring systems (C) affect the relevant treatment procedures (O)?

Search Strategy

Direct resources will be used in order to access information from primary researchers of depression. Search terms and criteria will include using the word “depression” and “systematic review”, and Boolean search string setting will focus on the publications since 2014. Five resources will be used from SAGE publications from which the relevant articles will be selected. The main exclusion criteria will be indirect sources and date of publication because articles written before 2014 will be considered as non-viable. The primary inclusion criteria are the presence of the keywords in the papers and their direct relevance to the subject.

Analysis of Literature

Table 1. Literature Analysis.

Author(s) Conceptual framework/theory Main finding Research method Strengths Weaknesses Level of evidence
(Guiraud et al., 2016) The main assumption is that depression has a highly negative effect on post-stroke rehabilitation because it is accompanied by depression. Females, people who suffered from heart stroke, and individuals with stressful lives are more likely to develop clinical depression symptoms. The researchers used the Patient Health Questionnaire alongside Mini-International Neuropsychiatric Interview, which allowed them to survey and diagnose patients (Guiraud et al., 2016). The critical strength of the study is that it uses highly precise numbers to draw a conclusion. The DEPRESS study specifies which patients had more frequent occurrences of depression (Guiraud et al., 2016). The primary weakness of the research is that its sample size is relatively small, which should be larger in PICO approach. The level of evidence is sufficient and specific enough to allow future studies to have more precise question format.
(Roseman et al., 2016) The main theory of the given study is to conduct a systematic review of various adolescent depression screening instruments and their accuracy. The main finding is that 16 out of 20 available depression screening tools are moderately accurate, whereas they were found to possess a low sensitivity level (Roseman et al., 2016). The key research method is a statistical analysis with confidence level set to 95% (Roseman et al., 2016). The biggest strength of the study is that it only uses mathematical evaluation of various instruments, which makes the research highly precise and narrow. The major weakness is the small number of depression screening tools. The review requires a larger sample size in order to make a convincing conclusion. The level of evidence is insufficient to make a specific claim, but it is also correct to assume that many tools are inaccurate.
(Fleischer, 2015) The main conceptual framework is Charles Brenner’s views on castration depression effect, where the study focuses on assessing these ideas. The primary finding is that biological factors play an essential role in identifying psychiatric solutions in order to ease depression symptoms. The study utilizes a number of clinical data on the given subject by overviewing the assessment failure rate (Fleischer, 2015). The key strength of the research is that it has access to a large amount of clinical information, which increases the statistical relevance of the results. The primary weakness is that clinical data available to the researcher is specific to location, whereas information from other hospitals is not included. The level of evidence is average, because it is mathematically accurate, but does not cover the entire scope of national clinical data.
(Vindbjerg, Makransky, Mortensen, & Carlsson, 2019) The main objective of the study is to analyze the effectiveness of the Hamilton Depression Rating Scale (HDRS) in non-Western nations. The results show that HDRS is a plausible tool to identify the depression features, which can be manifested in mood swings, guilt, unmotivated behavior, lower intelligence, and suicidal tendencies. The primary research method is a systematic review previously reported results, where HDRS was applied in non-Western cultures (Vindbjerg, Makransky, Mortensen, & Carlsson, 2019). The biggest strength of the study is that it focuses on non-Western countries, which will provide a more detailed review of the HDRS instrument. The main weakness lies in the fact that confirmatory factor analysis (CFA) is used in order to gather responses from independent samples, which might limit the amount of processed data (Vindbjerg et al., 2019). The level of evidence is strong because HDRS can still be applied as a crucial instrument to categorize depression levels.
(Bruce & Sirey, 2018) The main objective of the given study is to analyze the recent depression-related interventions among older adults. The key finding is that all three integrated care interventions, such as IMPACT, PRISM-E, and PROSPECT, are effective to apply for depression treatment in older adults. However, they should be used in combination because each method possesses certain limitations. The primary research method is an analysis and review of PROSPECT, IMPACT, and PRISM-E, which are major depression care interventions (Bruce & Sirey, 2018). The major strength of the study is that it includes data ranging from screening to treatment stages. The biggest weakness of the study is that it does not specify the limitations of each integrated care intervention. The level of evidence is strong due to the fact that it possesses a set of plausible strategies to apply with practical implications.

The best treatment option for the patient with depression is to use the mentioned screening, detection, and scoring methodologies in combination, because each approach possesses a unique set of benefits and limitations.

Conclusion

In conclusion, it is important to note that depression is present in various groups of people. These features might include cardiovascular issues, older age, and non-Western cultural origin. In addition, the current intervention and screening methodologies might not be highly accurate because they are designed to measure depression in specific individuals with unique conditions. In other words, the causes of the given mental disorder can highly vary, and there is no sufficient evidence to point out a primary factor that triggers depression.

Literature Matrix

Table 1. Literature Analysis.

Author(s) Conceptual framework/theory Main finding Research method Strengths Weaknesses Level of evidence
(Guiraud et al., 2016) The main assumption is that depression has a highly negative effect on post-stroke rehabilitation because it is accompanied by depression. Females, people who suffered from heart stroke, and individuals with stressful lives are more likely to develop clinical depression symptoms. The researchers used the Patient Health Questionnaire alongside Mini-International Neuropsychiatric Interview, which allowed them to survey and diagnose patients (Guiraud et al., 2016). The critical strength of the study is that it uses highly precise numbers to draw a conclusion. The DEPRESS study specifies which patients had more frequent occurrences of depression (Guiraud et al., 2016). The primary weakness of the research is that its sample size is relatively small, which should be larger in PICO approach. The level of evidence is sufficient and specific enough to allow future studies to have more precise question format.
(Roseman et al., 2016) The main theory of the given study is to conduct a systematic review of various adolescent depression screening instruments and their accuracy. The main finding is that 16 out of 20 available depression screening tools are moderately accurate, whereas they were found to possess a low sensitivity level (Roseman et al., 2016). The key research method is a statistical analysis with confidence level set to 95% (Roseman et al., 2016). The biggest strength of the study is that it only uses mathematical evaluation of various instruments, which makes the research highly precise and narrow. The major weakness is the small number of depression screening tools. The review requires a larger sample size in order to make a convincing conclusion. The level of evidence is insufficient to make a specific claim, but it is also correct to assume that many tools are inaccurate.
(Fleischer, 2015) The main conceptual framework is Charles Brenner’s views on castration depression effect, where the study focuses on assessing these ideas. The primary finding is that biological factors play an essential role in identifying psychiatric solutions in order to ease depression symptoms. The study utilizes a number of clinical data on the given subject by overviewing the assessment failure rate (Fleischer, 2015). The key strength of the research is that it has access to a large amount of clinical information, which increases the statistical relevance of the results. The primary weakness is that clinical data available to the researcher is specific to location, whereas information from other hospitals is not included. The level of evidence is average, because it is mathematically accurate, but does not cover the entire scope of national clinical data.
(Vindbjerg, Makransky, Mortensen, & Carlsson, 2019) The main objective of the study is to analyze the effectiveness of the Hamilton Depression Rating Scale (HDRS) in non-Western nations. The results show that HDRS is a plausible tool to identify the depression features, which can be manifested in mood swings, guilt, unmotivated behavior, lower intelligence, and suicidal tendencies. The primary research method is a systematic review previously reported results, where HDRS was applied in non-Western cultures (Vindbjerg et al., 2019). The biggest strength of the study is that it focuses on non-Western countries, which will provide a more detailed review of the HDRS instrument. The main weakness lies in the fact that confirmatory factor analysis (CFA) is used in order to gather responses from independent samples, which might limit the amount of processed data (Vindbjerg et al., 2019). The level of evidence is strong because HDRS can still be applied as a crucial instrument to categorize depression levels.
(Bruce & Sirey, 2018) The main objective of the given study is to analyze the recent depression-related interventions among older adults. The key finding is that all three integrated care interventions, such as IMPACT, PRISM-E, and PROSPECT, are effective to apply for depression treatment in older adults. However, they should be used in combination because each method possesses certain limitations. The primary research method is an analysis and review of PROSPECT, IMPACT, and PRISM-E, which are major depression care interventions (Bruce & Sirey, 2018). The major strength of the study is that it includes data ranging from screening to treatment stages. The biggest weakness of the study is that it does not specify the limitations of each integrated care intervention. The level of evidence is strong due to the fact that it possesses a set of plausible strategies to apply with practical implications.

References

Bruce, M. L., & Sirey, J. A. (2018). Integrated care for depression in older primary care patients. The Canadian Journal of Psychiatry, 63(7), 439-446.

Fleischer, L. M. (2015). Castration depression: Affect, signal affect, and/or depressive illness? Journal of the American Psychoanalytic Association, 63(2), 271-297.

Guiraud, V., Gallarda, T., Calvet, D., Turc, G., Oppenheim, C., Rouillon, F., & Mas, J. L. (2016). Depression predictors within six months of ischemic stroke: The DEPRESS Study. International Journal of Stroke, 11(5), 519-525.

Roseman, M., Kloda, L. A., Saadat, N., Riehm, K. E., Ickowicz, A., Baltzer, F., … Thombs, B. D. (2016). Accuracy of depression screening tools to detect major depression in children and adolescents: A systematic review. The Canadian Journal of Psychiatry, 61(12), 746-757.

Vindbjerg, E., Makransky, G., Mortensen, E. L., & Carlsson, J. (2019). Cross-cultural psychometric properties of the Hamilton Depression Rating Scale. The Canadian Journal of Psychiatry, 64(1), 39-46.

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