Depression

1. The changing
face of
depression
Depression Presenting
with Somatic
Manifestations
BY
Mostafa Mahmoud Elsabban
Lecturer of psychiatry
Al Azhar University- Damietta

2. Introduction

3. Introduction
Depressive disorders are common, with a prevalence of
5–10% in primary care settings.
They rank fourth as causes of disability
Worldwide.
The prevalence of depressive symptoms may be as
high as 30% in the general population.

5. Although effective
treatments are
available,
depression often
goes undiagnosed
and undertreated.

6. Suicide is the second
leading cause of death in
persons aged 20–35yrs,
and depressive disorder is a
major factor in around 50%
of these deaths.

7. Depressive disorder also
contributes to higher
morbidity and mortality
when associated with
other physical disorders
as MI, DM, HTN,…..

8. Diagnosis

9. SOMATZATION
PRMARY
SECONDARY TO:
Depression, Anxiety
others

10. The majority of patients with
depression will present to multiple
specialties,
often with problems other than low
mood

11. Core symptoms of
MDD
Non
Somatic
Symptoms
Somatic
symptoms

12. Non Somatic Symptoms
Depressed mood Anhedonia
Psychomotor agitation
or retardation
Inappropriate guilt
Death Wishes or suicide

13. Somatic Symptoms
Poor
concentration
Weight change
Disturbed
sleep
Fatigue or loss
of energy

14. Weight change
• loss of weight when not dieting or
• weight gain
• (e.g. a change of >5% of body weight in
a month),
• associated with or of appetite.

15. Disturbed sleep
• Insomnia [with early morning wakening (EMW) 2– 3hrs
sooner than usual] or
• Hypersomnia (especially in atypical depression)

16. Poor concentration
• Memory complaints.
• Indecisiveness.

17. Special
populations

18. Elderly persons
presenting with:
• Agitation,
• Confusion, or
• Pseudodementia.

20. Children
Children presenting with
symptoms such as:
• Irritability,
• Decline in school
performance (poor
concentration,
• Social withdrawal.
• Somatization as migraine,
abdominal ache

21. MANAGMENT

22. EXCLUDE
REFER
MINIMIZE THE STIGMA