最近审阅: 6 十一月 2020
最近更新: 19 十二月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 悲伤和/或易激惹情绪
  • 兴趣减少或缺乏乐趣
  • 严重的功能缺损
  • 无躁狂或轻躁狂发病证据
  • 无最近的伤恸病史

其他诊断因素

  • 注意力降低或犹豫不决
  • 失眠或睡眠过度
  • 食欲或体重变化
  • 过度疲乏
  • 无价值感或过度内疚
  • 感到绝望
  • 精神运动性激越或迟滞
  • 躯体主诉
  • 社交回避或朋友变化
  • 反复出现的死亡思想或自杀意念
  • 增加的物质使用

危险因素

  • 抑郁症的阳性家族史
  • 其他父母精神病变
  • 其他精神疾病(例如,焦虑障碍)的个人病史
  • 应激或外伤
  • 女性
  • 性别少数状态
  • 慢性内科疾病的个人病史
  • 出生后状态
  • 邻里和社会不稳定
  • 免疫抑制药物(例如,皮质类固醇、干扰素)
  • 物质使用/滥用

诊断性检查

需考虑的检查

  • 血清促甲状腺激素 (TSH) 和游离甲状腺素 (T4)
  • 全血细胞计数及分类
  • 尿液药物筛查
  • 尿液妊娠试验
  • 血清维生素 B12 和叶酸
  • 维生素 D 水平
更多 需考虑的检查

治疗流程

撰稿人

Assistant Professor of Psychiatry and Clinical and Translational Science

University of Pittsburgh

Attending Physician

Services for Teens at Risk

Pittsburgh

PA

利益声明

LP declares that she has no competing interests.

Endowed Chair in Suicide Studies

Professor of Psychiatry, Pediatrics, Epidemiology, and Clinical and Translational Science

University of Pittsburgh

PA

利益声明

DAB receives royalties from Guilford Press; has received or will receive royalties from the electronic self-rated version of the C-SSRS from ERT, Inc; is on the editorial board of UpToDate; is a reviewer for Healthwise; and is on the board of the Klingenstein Foundation.

Dr Lisa Pan and Dr David A. Brent would like to gratefully acknowledge Dr Rongrong Tao, Dr Graham Emslie, and Dr Taryn Mayes, the previous contributors to this topic. RT is an author of a number of references cited in this topic. GE has received research funds from BioMarin, Eli Lilly, Forest Laboratories, GlaxoSmithKline, and Somerset; has served as a consultant for Biobehavioral Diagnostic Company, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, GlaxoSmithKline, INC Research Inc., Lundbeck, Pfizer Inc., Seaside Therapeutics, Shire Pharmaceuticals, Valeant, Validus Pharmaceuticals, and Wyeth Ayerst; and has been on the speaker's bureau for Forest Laboratories. TM is an author of a number of references cited in this topic.

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Honorary Senior Lecturer

Institute of Child Health and Institute of Psychiatry

Consultant in Child and Adolescent Neuropsychiatry and Psychopharmacology

Head of Centre for Interventional Paediatric Psychopharmacology

Department of Child & Adolescent Mental Health

Great Ormond Street Hospital for Children

London

UK

利益声明

PJS declares that he has no competing interests.

Assistant Clinical Professor of Child Psychiatry

Yale School of Medicine

Medical Director of Psychiatry

Clifford W. Beers Guidance Clinic

New Haven

CT

利益声明

PJvW declares that he has no competing interests.

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