最近审阅: 27 十月 2020
最近更新: 05 十一月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 情绪低落
  • 兴趣缺乏
  • 功能缺损

其他诊断因素

  • 体重改变
  • 性欲改变
  • 睡眠障碍
  • 精神运动障碍
  • 精力不足
  • 过度自罪
  • 注意力不集中
  • 自杀观念
  • 除外双相情感障碍
  • 除外物质滥用/药物副作用
  • 除外躯体疾病
  • 除外精神分裂症

危险因素

  • 年龄 >65 岁
  • 出生后状态
  • 个人既往病史或家族史中曾有抑郁发作或自杀
  • 皮质类固醇
  • 干扰素
  • 普萘洛尔
  • 口服避孕药
  • 异维 A 酸
  • 共存的内科疾病 
  • 共患精神活性物质滥用
  • 人格障碍
  • 基因-环境相互作用

诊断性检查

首要检查

  • 临床诊断
  • 生化检查
  • 全血细胞计数(FBC)
  • 甲状腺功能检测
  • 患者健康问卷-2 (PHQ-2)
  • 患者健康问卷-9 (PHQ-9)
  • 爱丁堡产后抑郁量表 (Edinburgh Postnatal Depression Scale)
  • 老年抑郁量表
  • 康奈尔痴呆抑郁量表 (Cornell Scale for Depression in Dementia)
更多 首要检查

需考虑的检查

  • 24 小时游离皮质醇
  • 维生素 B12
  • 叶酸
更多 需考虑的检查

治疗流程

撰稿人

Associate Professor

Psychiatry and Behavioral Sciences

The Johns Hopkins Hospital

Baltimore

MD

利益声明

DFM declares that he has no competing interests.

Dr Dean F. MacKinnon would like to gratefully acknowledge Dr Roger S. McIntyre, Dr Tonya Fancher, and Dr Richard Kravitz, the previous contributors to this topic.

利益声明

RSM has received research funds from Stanley Medical Research Institute and National Alliance for Research on Schizophrenia and Depression (NARSAD). RSM is on the advisory board for AstraZeneca, Bristol-Myers Squibb, France Foundation, GlaxoSmithKline, Janssen-Ortho, Solvay/Wyeth, Eli Lilly, Organon, Lundbeck, Biovail, Pfizer, Shire, and Schering-Plough. RSM is on the Speakers Bureau for Janssen-Ortho, AstraZeneca, Eli Lilly, Lundbeck, Biovail, and Wyeth. RSM has received research grants from Eli Lilly, Janssen-Ortho, Shire, and AstraZeneca. RSM has received travel funds from Bristol-Myers Squibb. TF declares that she has no competing interests. RK has received research grants from Pfizer on non-depression-related topics.

同行评议者展开全部内容

Director

Residency Training

St Vincent's Hospital

Manhattan

NY

利益声明

SM declares that he has no competing interests.

Department of Psychiatry and Psychotherapy

Medical University of Vienna

Vienna

Austria

利益声明

DW has received lecture fees from CSC Pharmaceuticals, GlaxoSmithKline, and Pfizer, and has served as a consultant for GlaxoSmithKline.

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