Clinical depression history and symptoms
|
Clinical Depression Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Follow-up |
|
Case Studies |
|
Clinical depression history and symptoms On the Web |
|
American Roentgen Ray Society Images of Clinical depression history and symptoms |
|
Risk calculators and risk factors for Clinical depression history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Depression is difficult to diagnose accurately. Primary care physicians and other non-psychiatrists physicians miss two-thirds of cases and unnecessarily treat other patients.[1][2]
Before a diagnosis of depression is made, a physician should perform a complete medical exam to rule out any possible physical cause for the suspected depression. If no such cause is found, a psychological evaluation should be done by the physician or by referral to a psychiatrist or psychologist. The evaluation will include a complete history of symptoms, a discussion of alcohol and drug use, and whether the patient has had or is having suicidal thoughts or thinking about death. The evaluation will also include a family medical history to see if other family members suffer from any form of depression or similar mood disorder.
History and Symptoms
Clinical depression can present with a variety of symptoms, but almost all patients display a marked change in mood, a deep feeling of sadness, and a noticeable loss of interest or pleasure in favorite activities. Other symptoms include:
- Persistent sad, anxious or "empty" mood
- Loss of appetite and/or weight loss or conversely overeating and weight gain
- Insomnia, early morning awakening, or oversleeping
- Restlessness or irritability
- Psychomotor agitation or psychomotor retardation
- Feelings of worthlessness, inappropriate guilt, helplessness
- Feelings of hopelessness, pessimism
- Difficulty thinking, concentrating, remembering or making decisions
- Thoughts of death or suicide or attempts at suicide
- Loss of interest or pleasure in hobbies and activities that were once enjoyed
- Withdrawal from social situations, family and friends
- Decreased energy, fatigue, feeling "slowed down" or sluggish
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive problems, and chronic pain
Not all patients will present every symptom, and the severity of symptoms will vary widely among individuals. Symptoms must, however, persist for at least two weeks before being considered a potential sign of depression, with the exception of suicidal thoughts or attempts.
Diagnosis of clinical depression in children is more difficult than in adults and is often left undiagnosed, and thus untreated, because the symptoms in children are often written off as normal childhood moodiness. Diagnosis is also made difficult because children are more likely than adults to show different symptoms depending on the situation.[3]
While some children still function reasonably well, most who are suffering depression will suffer from a noticeable change in their social activities and life, a loss of interest in school and poor academic performance, and possibly drastic changes in appearance. They may also begin abusing drugs and/or alcohol, particularly past the age of 12. Although much rarer than in adults, children with major depression may attempt suicide or have suicidal thoughts even before the age of 12.[3]
References
- ↑ Cepoiu M, McCusker J, Cole MG, Sewitch M, Belzile E, Ciampi A (2008). "Recognition of depression by non-psychiatric physicians--a systematic literature review and meta-analysis". J Gen Intern Med. 23 (1): 25–36. doi:10.1007/s11606-007-0428-5. PMID 17968628.
- ↑ Mitchell AJ, Vaze A, Rao S (2009). "Clinical diagnosis of depression in primary care: a meta-analysis". Lancet. 374 (9690): 609–19. doi:10.1016/S0140-6736(09)60879-5. PMID 19640579. Review in: Evid Based Med. 2010 Feb;15(1):29-30 Review in: Ann Intern Med. 2010 Apr 20;152(8):JC4-13
- ↑ 3.0 3.1 "Depression in Children". MedicineNet.com and the Cleveland Clinic. 2005-01-31. Retrieved 2007-10-21.