A Case on Depression

Final Year Medical Student

Grand Round

Background

• One of the most common reasons for

consultation1

• Second most common cause of disability

worldwide 2

• Female : Male 2:13

http://en.wikipedia.prg4

DifferentialDiagnosis

Depression

Iron/B12/Folate Deficiency Hypothyroidism

Mixed anxiety & Depressive disorder Cyclothymic

disorder

Substance misuse

Classification5

Symptoms:

↓moodLoss of interest↓energy

↓concentration↓self-esteemGuilt/worthlessnessPessimistic thoughtsIdeas of self-harmDisturbed sleepDiminished appetite

Mild

|} any 2|

|||} any 2|||

Moderate

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|||} any 3|||

Severe

|} all 3|

|||} ≥ 4|||

Miss B

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MODERATE

References

1) Shah A. The burden of psychiatric disorder in primary care. Int Rev Psych, 1992; 4:243-250

2) NHS Centre for reviews and dissemination. Improving the recognition and management of depression in primary care. Effective Health Care, 2000; 7.

3) Astbury J, Cabral M. Women’s mental health: an evidence based review. Geneva World Health Organisation, 2000.

4) Clinical Depression. http://en.wikipedia.org/

5) The ICD-10 Classification of mental and behavioural disorders. Geneva World Health Organisation, 1992.

Any questions?