持续性抑郁障碍

最后审阅: 7 九月 2022
最后更新: 10 八月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 慢性心境障碍需持续超过 2 年
  • 抑郁症状出现在大多数日子里每一天的大多数时间
  • 在过去 2 年(儿童或青少年为 1 年)没有出现过一段时间的情绪高涨
  • 重性抑郁的症状可能持续出现 2 年或更长的时间
更多 关键诊断因素

其他诊断因素

  • 没有躁狂/轻症躁狂或精神分裂症的症状
  • 不存在可能引起心境障碍的躯体疾病、药物使用或物质滥用
  • 疲劳或精力不足
  • 自卑
  • 注意力不集中或犹豫不决
  • 感到绝望
  • 食欲不振或进食过量
  • 睡眠障碍
其他诊断因素

危险因素

  • 阳性家族史
  • 女性
更多 危险因素

诊断性检查

首要检查

  • 医学鉴定
  • 全血细胞计数 (FBC)
  • 甲状腺功能检测
  • 生化检查
  • 维生素 D
  • 患者健康问卷 (PHQ-9)
  • Beck抑郁量表 (BDI)
  • 抑郁症状快速清单 (QIDS)
更多 首要检查

需考虑的检查

  • 维生素 B12
  • 尿液检查
  • 心电图(ECG)
更多 需考虑的检查

治疗流程

急症处理

所有患者

撰稿人

作者

David J. Hellerstein, MD
David J. Hellerstein

Professor of Clinical Psychiatry

Columbia University Medical Center

Director, Depression Evaluation Service

New York State Psychiatric Institute

New York

NY

利益声明

DJH has received grant support from Eli Lilly, Pfizer, Forest Pharmaceuticals, GlaxoSmithKline, Bristol-Myers Squibb, GeneSight, Marinus, Takeda, Intracellular Therapies, and Compass Pathways. He is an author of a number of references cited in this topic.

鸣谢

Dr David J. Hellerstein would like to gratefully acknowledge Dr David L. Dunner, a previous contributor to this topic.

利益声明

DLD has received grant support from Cyberonics. DLD has received fees for consulting from: Eli Lilly, Pfizer, GlaxoSmithKline, Wyeth, Bristol-Myers Squibb, Forest, Cyberonics, Roche Diagnostics, Cypress, Corcept, Janssen, Novartis, Shire, Somerset, Otsuka, Healthcare Technology Sys, Jazz Pharma, Sanofi-Aventis, and MedAvante. DLD is on the Speaker's Bureau for: Eli Lilly, Pfizer, GlaxoSmithKline, Wyeth, Bristol-Myers Squibb, Organon, Jazz Pharma, Neuronetics, and Astra-Zeneca. DLD is an author of several references cited in this topic.

同行评议者

Dean F MacKinnon, MD

Associate Professor

John Hopkins University

Baltimore

MD

利益声明

DK declares that he has no competing interests.

James H Kocsis, MD

Professor

Weill Cornell Medicine

New York

NY

利益声明

JK has professionally collaborated with the authors.

Neil Nixon, BSc, MMedSci, MBBS, FRCPsych

Associate Professor in Psychiatry

Institute of Mental Health

University of Nottingham

Nottingham

UK

利益声明

NN is a member of the current NICE GDG for depression in adults. NN has met with Jansen in a non-remunerative capacity. He has various research collaborations including a funded trial and is author on a number of papers.

  • 鉴别诊断

    • 重性抑郁障碍 (MDD)
    • 双相障碍(双向 I 型、双向 II 型、非特定型双相障碍)
    • 循环性心境障碍
    更多 鉴别诊断
  • 指南

    • 成人抑郁:治疗和管理
    • 儿童和年轻人抑郁症:识别和管理
    更多 指南
  • 患者教育信息

    成人抑郁:是什么?

    成人抑郁:什么治疗有效?

    更多 患者教育信息
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