Psychometrics! In particular the ones that answer the question, am I depressed?...
Psychometrics! In particular the ones that answer the question, am I depressed?
The Hamilton (HDRS) scale has several groups of questions & is measuring several things.
- sleep gets disproportionate attention
- debilitating things get scored the same as nuisances
- it expects you to remember what happened on a daily basis for last 2 weeks.
Self-replies
PQ9 is an evolution of the scale and is less awful but still is obviously inspired by the HDRS.
If you were a drug company and wanted to hack the score, just make a pill that fixes people's sleep and fidgeting (give 'em a downer pill) and voila, they sleep and you didn't have to address anything.
Also, In the last 65 years, we've learned that depression is many things and often a cluster of Depression, Anxiety, and Anger, or a emotion dysregulation phenomena. The PQ9 ignores the other emotions that are too volatile or stuck too low or stuck too high or too easily triggered.
Metaphor time...
ALSO, drugs are like monetary policy. Flood the economy with cash to increase economic activity. It has 1 direction.
Fixing a dysregulated system needs to be more like the Fed, always increasing/decreasing money supply when the economy is too hot or cold.
Anyhow, bipolar people are a good example of people whose mood "economy" can be too slow or overheated.
Anyhow, the whole thing is based on 65 year old bad psychometrics (drugs were approved on how they affected HDRS scores!)
I bet pubmed probably has a dozen measures that are less stupid from 25 years ago that are being ignored