How do you assess the severity of a depressive episode for a report?

Severity is assessed against the ICD-11 criteria for mild, moderate and severe depressive episodes, considering the number and intensity of symptoms, their duration, and their effect on functioning, cross-checked against the GP and any specialist records rather than relying on the interview account alone.

Can you address bereavement claims where grief and depression overlap?

Yes. The report distinguishes an ordinary grief reaction from a depressive disorder or prolonged grief disorder using the ICD-11 criteria, and explains the basis for the distinction rather than treating grief and depression as interchangeable.

What weight do you give to a pre-existing history of anxiety or depression?

A pre-existing history is addressed directly. The opinion considers the likely course of the pre-existing condition absent the index event and apportions the current presentation between that condition and the index event so far as the evidence allows.

Will the report comment on fitness to return to a specific job?

Where the instruction asks and sufficient information about the role is provided, the report addresses capacity to return to the previous role, to an alternative role, or to work at all, and the timescale over which that capacity might change with treatment.

How is relapse risk assessed?

Relapse risk is assessed against recognised risk factors — number of prior episodes, residual symptoms, ongoing stressors and treatment adherence — and expressed as a reasoned opinion rather than a percentage, since the evidence rarely supports that degree of precision.

Anxiety and depression expert witness in Scotland

Depressive and anxiety disorders are the most commonly encountered psychiatric consequence of an accident, an assault, a workplace event or a bereavement, and they are also the diagnoses most often disputed on grounds of severity, duration and causation. A report needs to establish not simply that low mood or anxiety is present, but its severity against recognised classification, its likely duration, the contribution of the index event as against other stressors, and the risk of relapse.

I am instructed by pursuer agents, defender agents and insurers in personal injury, employment and clinical negligence actions, and in each case the diagnostic and causation analysis follows the same method regardless of which party has instructed the report.

Scope of opinion

What I can advise on

Whether the presentation meets ICD-11 criteria for a depressive episode or an anxiety disorder, and the severity of that episode — mild, moderate or severe.
Whether the index event caused, materially contributed to, or accelerated the disorder found.
The contribution of other concurrent stressors — financial, relationship, occupational — to the presentation.
Duration to date, expected further duration, and the basis for that prognosis.
Response to medication and psychological treatment received to date, and what further treatment is reasonably required.
Risk of relapse, and factors that would increase or reduce that risk going forward.
Effect on capacity to work, to return to a previous role, and to carry out domestic and social activities.
Apportionment where there is a pre-existing psychiatric history or an unrelated event has contributed to the current presentation.

Where the presentation suggests a personality disorder, a substance use disorder, or a degree of cognitive impairment requiring specialist testing, I say so and identify the discipline better placed to address it rather than extend the opinion beyond what the evidence supports.

Typical instructions

Moderate depressive episode following a workplace grievance: An employee who developed depressive symptoms during a prolonged grievance and disciplinary process. The instruction asks whether the process itself is capable of causing the disorder found, and how the presentation should be apportioned as between the employer's conduct and the employee's pre-existing vulnerability.
Generalised anxiety disorder after a road traffic accident: A pursuer whose anxiety symptoms are pervasive rather than confined to travel, raising the question of whether generalised anxiety disorder or a specific travel-related phobia better describes the presentation, and what that distinction means for prognosis.
Complicated grief following a fatal accident: A close relative of a person killed in an accident who has not returned to work two years later. The instruction distinguishes ordinary bereavement from a depressive disorder or prolonged grief disorder, and addresses what treatment and further period of incapacity should be allowed for.
Relapse risk in a pursuer with a prior depressive history: A pursuer with two earlier depressive episodes, unrelated to the index event, who has now suffered a further episode following an assault. The opinion addresses the likely trajectory without the assault and the additional risk of relapse attributable to it.

The report

What the report includes

The report sets out the instructions received, documents considered, personal and family history, past psychiatric history including any earlier episodes of depression or anxiety, an account of the index event and the symptoms that followed it, mental state examination, and a reasoned opinion addressing severity, causation, prognosis and treatment need in turn.

Where medication has been prescribed, the report reviews the dose, duration and response recorded in the GP records, and comments on whether that history is consistent with the severity claimed at interview. Where psychological treatment has already been provided, its content and the examinee's response to it are considered as part of the prognosis.

The opinion closes with a clear statement on relapse risk and the factors that bear on it, followed by the statement of truth and declaration of independence expected of expert evidence in the Scottish courts.

Timescales

Timescales and format

Assessment is offered in Greater Glasgow, at an agreed venue elsewhere in Scotland, or by secure video where appropriate to the individual's presentation and travel circumstances. The interview usually takes between 90 minutes and two hours.

Turnaround runs from receipt of complete records, including GP records covering any pre-existing psychiatric history: [CLIENT TO CONFIRM: X weeks]. Where a proof diet is fixed, confirm the date at enquiry stage before instruction.

Supplementary reports on further records, joint reports with the opposing expert and attendance at proof are available on the terms set out under fees and timescales.

Questions

Frequently asked questions

How do you assess the severity of a depressive episode for a report?: Severity is assessed against the ICD-11 criteria for mild, moderate and severe depressive episodes, considering the number and intensity of symptoms, their duration, and their effect on functioning, cross-checked against the GP and any specialist records rather than relying on the interview account alone.
Can you address bereavement claims where grief and depression overlap?: Yes. The report distinguishes an ordinary grief reaction from a depressive disorder or prolonged grief disorder using the ICD-11 criteria, and explains the basis for the distinction rather than treating grief and depression as interchangeable.
What weight do you give to a pre-existing history of anxiety or depression?: A pre-existing history is addressed directly. The opinion considers the likely course of the pre-existing condition absent the index event and apportions the current presentation between that condition and the index event so far as the evidence allows.
Will the report comment on fitness to return to a specific job?: Where the instruction asks and sufficient information about the role is provided, the report addresses capacity to return to the previous role, to an alternative role, or to work at all, and the timescale over which that capacity might change with treatment.
How is relapse risk assessed?: Relapse risk is assessed against recognised risk factors — number of prior episodes, residual symptoms, ongoing stressors and treatment adherence — and expressed as a reasoned opinion rather than a percentage, since the evidence rarely supports that degree of precision.

Instructing

Instructing Dr Qureshi

Instructions are accepted from pursuer and defender agents, insurers, regulatory bodies and occupational health providers. A conflict check is carried out before any instruction is accepted.

Send a letter of instruction Check availability and conflicts

Or call 07739 587092.