Depression: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
Must have 5 of the following features for major depressive disorder for >2 wks<ref>American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.</ref> | |||
*Depressed mood or anhedonia (must be present) | |||
*SIGECAPS | |||
**Sleep decreased (Insomnia with 2-4 am awakening) | |||
**Interest decreased in activities | |||
**Guilt or worthlessness (Not a major criteria) | |||
**Energy decreased | |||
**Concentration difficulties | |||
**Appetite disturbance or weight loss | |||
**Psychomotor retardation/agitation | |||
**Suicidal thoughts | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 17:57, 9 October 2015
Background
Clinical Features
Must have 5 of the following features for major depressive disorder for >2 wks[1]
- Depressed mood or anhedonia (must be present)
- SIGECAPS
- Sleep decreased (Insomnia with 2-4 am awakening)
- Interest decreased in activities
- Guilt or worthlessness (Not a major criteria)
- Energy decreased
- Concentration difficulties
- Appetite disturbance or weight loss
- Psychomotor retardation/agitation
- Suicidal thoughts
Differential Diagnosis
General Psychiatric
- Organic causes
- Psychiatric causes
Diagnosis
General ED Psychiatric Workup
- Point-of-care glucose
- CBC
- Chem 7
- LFTs
- ECG (for toxicology evaluation)
- ASA level
- Tylenol level
- Urine toxicology screen/Blood toxicology screen
- EtOH
- Urine pregnancy/beta-hCG (if female of childbearing age)
- Consider:
- Ammonia (see Hepatic encephalopathy)
- TSH (hypo or hyperthyroidism may mimic mental illness)
- CXR (for Tb screen or rule-out delirium in older patient)
- UA (for rule-out delirium in older patients)
- Head CT (to rule-out ICH in patients with AMS)
- Lumbar puncture (to rule-out meningitis or encephalitis)
Management
Disposition
See Also
External Links
Sources
- ↑ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.