Depression diagnosis

Goodnick PJ, Dominguez RA, DeVane L, et al. Bupropion slow-release response in depression diagnosis and biochemistry. Biol Psychiatry 1998 44 629-632. 

Miscellaneous Vasculitis/inflammatory Sarcoidosis/porphyria Dementia pugilistica (recurrent head trauma) Parkinson s disease/Huntington s disease Pseudodementia of depression Diagnosis and treatment varies... 

Because alcohol intoxication may be simulated by many pathologic conditions, including diabetic acidosis, the postconvulsive depression of epilepsy, uremia, head injuries, and poisonings by any other central nervous depressant and some stimulants (280), a diagnosis of acute alcoholism should not be made casually chemical testing of blood, urine, or expired air is always desirable. 

This drug is used for complete or partial reversal of narcotic depression, including respiratory depression. Narcotic depression may be due to intentional or accidental overdose (self-administration by an individual), accidental overdose by medical personnel, and drug idiosyncrasy Naloxone also may be used for diagnosis of a suspected acute opioid overdosage. 

If the patient lias an order for a PRN narcotic analgesic or odier CNS depressant and a hypnotic, die nurse should consult die primary healdi care provider regarding die time interval between administration of tiiese drugp. Usually at least 2 hours should elapse between administration of a hypnotic and any odier CNS depressant, but this interval may vary, depending on factors such as die patient s age and diagnosis. 

Medications that have been used as treatment for anxiety and depression in the postwithdrawal state include antidepressants, benzodia2epines and other anxiolytics, antipsychotics, and lithium. In general, the indications for use of these medications in alcoholic patients are similar to those for use in nonalcoholic patients with psychiatric illness. However, following careful differential diagnosis, the choice of medications should take into account the increased potential for adverse effects when the medications are prescribed to alcoholic patients. For example, adverse effects can result from pharmacodynamic interactions with medical disorders commonly present in alcoholic patients, as well as from pharmacokinetic interactions with medications prescribed to treat these disorders (Sullivan and O Connor 2004). 

The diagnosis of a major depressive episode requires the presence of a certain number of depressive symptoms (five) for a minimum specified duration (2 weeks) that cause clinically significant effects (Table 35—l).3... 

In turn, the diagnosis of MDD is based on the presence of one or more major depressive episodes during a person s lifetime.3... 

Cohen LS, Nonacs R, Viguera AC, Reminick A. Diagnosis and treatment of depression during pregnancy. CNS Spectr 2004 9 209-216. 

Hospitalized at age 15 for physical aggression towards parents, suicidality, and running away does not remember if she was placed on medication or if she was given a diagnosis admits history of sleep disturbance that alternates between hyposomnia and hypersomnia and moodiness, when she shifts from feeling "on top of the world" to very depressed, "like I m a nobody."... 

Bipolar disorder can be conceptualized as a continuum or spectrum of mood disorders and is not comprised solely of bipolar I disorder.9 They include four subtypes bipolar I (periods of major depressive, manic, and/or mixed episodes) bipolar II (periods of major depression and hypomania) cyclothymic disorder (periods of hypomanic episodes and depressive episodes that do not meet all criteria for diagnosis of a major depressive episode) and bipolar disorder, NOS. The defining feature of bipolar disorders is one or more manic or hypomanic episodes in addition to depressive episodes that are not caused by any medical condition, substance abuse, or other psychiatric disorder.1... 

Lifetime prevalence rates of psychiatric comorbidity co-existing with bipolar disorder are 42% to 50%.16 Comorbidities, especially substance abuse, make it difficult to establish a definitive diagnosis and complicate treatment. Comorbidities also place the patient at risk for a poorer outcome, high rates of suicidal-ity, and onset of depression.2 Psychiatric comorbidities include ... 

Kleinman (1986) claimed that neurasthenia was a cultural form of chronic somatization that outlined several different types of psychopathological disorders, the major depressive disorder included in western classifications being the one that best accounted for this disorder. This would explain the lower rate of prevalence of the diagnosis of depressive disorder among the Chinese population. 

The classic symptoms of depression are listed in Table 12.1, which is based on DSM-IV criteria. For a diagnosis of major depressive disorder, most of these symptoms must be present, including the first two (APA, 2000). These symptoms should be of sufficient intensity and chronic duration (at least 2 weeks) to cause clinically significant distress and impairment in social or economic functioning. However, they should not be a result of another psychiatric or somatic illness, nor of drug misuse or bereavement. For a diagnosis of mania, the symptoms are a mirror image of those for depression (Table... 

Tyrcr P, Seivewright N, Ferguson B and Tyrer J (1992). The general neurotic syndrome A coaxial diagnosis of anxiety, depression and personality disorder. Acta Psychiatra Scan-dinavica, 85, 201-206. 

A diagnosis of major depression can be made when items A-F are fulfilled ... 

Reproduced from [38, 39] with permission Tab. 19.3 Differential diagnosis of depression... 

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