Depression rehabilitation patients

Affective disorders such as depression and manic-depression are found frequently in the general population as well as in rehabilitation patients. Drugs commonly prescribed in the treatment of (unipolar) depression include the tricyclics and MAO inhibitors as well as the newer second-generation antidepressants. Lithium is the drug of choice for treating bipolar disorder, or manic-depression. All of these drugs... 

Antidepressants are only recommended in the rehabilitation and continuing care stages of treatment for alcohol and cocaine dependence if the patient has a comorbid depressive or anxiety disorder. 

The full spectrum of depressive symptoms including depressed mood, anhedonia, lack of energy, and even suicidal thoughts may strike as many as 25% of patients who experience a TBL Depression in these patients not only exacts a tremendous psychosocial toll but also interferes with their participation in physical and occupational rehabilitation. As a result, long-term functional recovery from TBl can be sorely compromised by depression. Potential treatments for post-TBl depression include conventional antidepressants and stimulants (see Table 12.1). 

After detoxification, psychosocial therapy either in intensive inpatient or in outpatient rehabilitation programs serves as the primary treatment for alcohol dependence. Other psychiatric problems, most commonly depressive or anxiety disorders, often coexist with alcoholism and, if untreated, can contribute to the tendency of detoxified alcoholics to relapse. Treatment for these associated disorders with counseling and drugs can help decrease the rate of relapse for alcoholic patients. 

Because these forms of mental illness are relatively common, many rehabilitation specialists will work with patients who are receiving drug therapy for an affective disorder. Also, serious injury or illness may precipitate an episode of depression in the patient undergoing physical rehabilitation. Consequently, this chapter will discuss the pharmacologic management of affective disorders, as well as how antidepressant and antimanic drugs may influence the patient involved in physical therapy and occupational therapy. 

Don t overlook hypoactive delirium lethargy and psychomotor retardation. The well-behaved patient, sitting quiedy and fully compliant may be extremely unwell. These patients are often referred for depression or poor engagement with rehabilitation. 

Opsonic activity for E. coll strains opsonized via either pathway of complement activity was also moderately decreased. Considering the fact that hemolytic complement activity and opsonin levels to these organisms are equal to values found in control patients when acute PEM patients are fully rehabilitated, it must be concluded that baseline complement levels and function are depressed in mild-moderate malnutrition. However, when the presence of recent inflammatory processes was screened by elevation of C-reactive... 

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