Depressive disorders

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Diagnosis is established if the patient has at least two of the core symptoms (bold) plus two other symptoms. Minimum duration of 2 weeks with sustained dysfunction.

Depression is classified into mild (few or none somatic symptoms) moderate and severe depending on the symptoms the patient has and the impact they have on his/her life.

 

Symptoms

  • Lowering of mood

  • Anhedonia

  • Reduction of energy

  • Decreased concentration

  • Reduced self-esteem / self-confidence

  • Ideas of guilt or worthlessness

Somatic symptoms

  • Psychomotor retardation

  • Poor sleep

  • Early morning waking

  • Worse in morning

  • Loss of appetite

  • Loss of weight

  • Loss of libido

When to assess...

-  Affective symptoms / behaviour
-  Suicidal / Self harm
-  Evidence of self neglect
-  Increased alcohol intake
-  Neurotic or Eating disorders
-  Unexplained fatigue / illness
-  History of affective disorders
-  Family history affective disorders

 

Diagnostic interview question tips...

 

Mood symptoms

'How do you feel in you yourself? How is your emotional state?'
'Does your mood change during the course of the day…?'
'Do you get annoyed at things which normally wouldn't annoy you?'
'Can you still feel happy or exited when something good happens?'
'Do you still enjoy doing your hobbies?'

Psychological

'What’s been on your mind recently...?'
'How do you feel comfortable in yourself?'
'Do you feel valued and needed?'

Attention / Concentration

'How have you been spending your time recently...?'
'Can you read a book or an article and remain focused?'
'Are you able to stay focused during a TV programme or DVD?'

Energy / Activity

'Have you noticed a change in your energy levels? (energy)'
'Do you tire easier than before?'
'Do you still do as much as you did before you felt like this?'
'Have you kept on top of your day to day tasks like housekeeping...?'

Sleep (this can increase or decrease in depression)

'Have you been getting as much sleep as you normally do?'
'Has you sleeping pattern changed at all?'

Appetitive (this can increase or decrease in depression)

'How has your appetitive been? Has your eating routine changed?'
'Has your interest in sex changed? how so?'
'Have you lost any weight recently? how much? are you on a diet? is there any other reason for this?'

 

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