Depression PMHN ONLINE
Veraguth’sFoldThis triangular shapedfold of the forehead isassociated withdepression.
Depression General description   Psychomotor retardation   Hand wringing and hair pulling in agitated subtypes   Stoop...
 Speech   Decreased rate and volume   Monosyllabic responses to questions   Retarded delay response to questions Perc...
   Sensorium and cognition       Oriented times three       Impaired concentration       Impaired memory (forgetfulnes...
Dysthymia Depressed mood for most days for more than two years    Associated with poor adjustment to adolescence    Ass...
 Prognosis of dysthymia   25% do not respond fully to treatment   10% stay in remission with treatment           Dysthy...
Cyclothymia Mild form of Bipolar 11 disorder   Episodes of hypomania and mild depression May be a form of borderline pe...
Childhood Depression School phobia & excessive clinging to parents are  often signs of depression in children Teen depre...
Depression in Older People Associated with multiple losses Correlated with low socio-economic class Concurrent with phy...
Laboratory Values for Depression Dexamethasone depression test is questionable Low FBS in major depression Abnormal thy...
Assessment Tools for Depression Hamilton Rating Scale for Depression (British Journal of  Psychiatry, 1959: 32-50 Zung S...
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Depressiononline

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Depressiononline

  1. 1. Depression PMHN ONLINE
  2. 2. Veraguth’sFoldThis triangular shapedfold of the forehead isassociated withdepression.
  3. 3. Depression General description  Psychomotor retardation  Hand wringing and hair pulling in agitated subtypes  Stooped posture  Downward cast to eyes in American culture Mood affect and feelings  Feeling sad or depressed in 50 % of patients  Other 50 % deny feeling depressed but are socially withdrawn and anergic
  4. 4.  Speech  Decreased rate and volume  Monosyllabic responses to questions  Retarded delay response to questions Perceptual Disturbances seen in Major Depression  Delusions  Mood congruent- guilt, shame, sinfulness, worthlessness, poverty, failure, somatic illness  Hallucinations  Catatonia
  5. 5.  Sensorium and cognition  Oriented times three  Impaired concentration  Impaired memory (forgetfulness) Impulse control  10-15% commit suicide (usually upon getting treatment for a couple of weeks; ↑energy) Insight  Patients exaggerate symptoms and feelings of depression  Negative cognitive triad  (I do not feel good: I never felt good; I will never feel good) Course  50 % of cases first depressive episode starts before age 40  Untreated episodes last 6 to 13 months  Treated episodes last three months  Subsequent episodes are more frequent and last longer Prognosis  Poor; major depressive disorders are most often recurring. Treatment is for life
  6. 6. Dysthymia Depressed mood for most days for more than two years  Associated with poor adjustment to adolescence  Associated with chronic illness  Hyperphagia or hypophagia  Hypersomnia or hyposomnia Dysthymic patients can also suffer from a minor or major depressive disorder in what is then called a “double depression”-poor prognosis
  7. 7.  Prognosis of dysthymia  25% do not respond fully to treatment  10% stay in remission with treatment Dysthymia
  8. 8. Cyclothymia Mild form of Bipolar 11 disorder  Episodes of hypomania and mild depression May be a form of borderline personality rather than a mood disorder Depression is the most prominent mood Substance abuse common co-morbidity
  9. 9. Childhood Depression School phobia & excessive clinging to parents are often signs of depression in children Teen depression is characterized by  Poor academic performance  Substance abuse  Antisocial behavior  Sexual promiscuity  Truancy  Running away Depression at a Young Age
  10. 10. Depression in Older People Associated with multiple losses Correlated with low socio-economic class Concurrent with physical illness and isolation
  11. 11. Laboratory Values for Depression Dexamethasone depression test is questionable Low FBS in major depression Abnormal thyroid function tests indicating hypothyroidism in depression
  12. 12. Assessment Tools for Depression Hamilton Rating Scale for Depression (British Journal of Psychiatry, 1959: 32-50 Zung Self-rating Depression Scale (Archives of General Psychiatry, 1973; 28 361-366) Beck Depression Inventory

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