depression report of patient

How many people are actually affected by depression every year?

Who Gets Depression? In general‚ about 1 out of every 6 adults will have depression at some time in their life. 3 Depression affects about 16 million American adults every year. 4 Anyone can get depressed, and depression can happen at any age and in any type of person. Many people who experience depression also have other mental health conditions. 1,5 Anxiety disorders often go hand in hand ...

How is depression detected and treated?

Your doctor can use blood tests to rule out medical conditions that may cause symptoms of depression or even be an underlying cause of the condition. Depending on the results of the blood tests, the next step may be getting a referral to another type of doctor, such as a psychiatrist or another mental health provider.

How to identify depression?

When you write down what is bothering you, it makes it easier to identify your stressors. Once you determine what is contributing to your depression, you can start to formulate a game plan to face it head on. You only need to spend about 10 minutes a day writing in your journal.

What are the statistics on depression?

Depression is one of the most prevalent mental health conditions in the US. According to the 2017 National Survey on Drug Use and Health (NSDUH), about 17.3 million adults (=7.3% of all US adults) in the US had at least one major depressive episode in the previous year. About 11 million adults (=4.5% of all US adults) ‘had at least one major depressive episode with severe impairment’.

How do you assess a patient for depression?

Patient Health Questionnaire (PHQ-9) The Patient Health Questionnaire (PHQ) is a self-report measure designed to screen depressive symptoms. It takes one to five minutes to complete and roughly the same amount of time for a clinician to review the responses. The PHQ-9 is available in multiple languages.

What are the findings of depression?

Symptoms of Depression Persistent sad mood. Feelings of hopelessness. Feelings of guilt or worthlessness. Loss of interest or pleasure in hobbies or enjoyable activities, including sex.

How can you tell if a patient is depressed?

Signs and SymptomsPersistent sad, anxious, or “empty” mood.Feelings of hopelessness, or pessimism.Irritability.Feelings of guilt, worthlessness, or helplessness.Loss of interest or pleasure in hobbies and activities.Decreased energy or fatigue.Moving or talking more slowly.More items...

What is self reported depression?

In this article, when referring to previous research, we use the term used by the original authors, and as to our own research, we use term “self-reported depression” as referring to those who scored above cut-point for depression in our data.

What is a summary of depression?

Summary. Depression is a constant feeling of sadness and loss of interest, which stops you doing your normal activities. Different types of depression exist, with symptoms ranging from relatively minor to severe. Generally, depression does not result from a single event, but from a mix of events and factors.

What are the 5 characteristics of depression?

Despite a huge range of symptoms here are five of the most common characteristics that the majority of people with depression experience:Low mood/low interest in activities enjoyed previously: ... Trouble concentrating: ... Changes in appetite or sleep: ... Feeling hopeless/worthless: ... Thoughts of suicide:

What are the 4 main causes of depression?

Here are four of the main ones.Genetics. One of the most influential factors in the onset of major depression is outside your control: your genetic code. ... Substance Abuse. ... Early Childhood Experiences. ... Major Life Events (Both Immediate and Prolonged)

What increases the risk of depression?

Risk factors for depressionfamily history and genetics.chronic stress.history of trauma.gender.poor nutrition.unresolved grief or loss.personality traits.medication and substance use.

What is a PHQ test?

MEASUREMENTS. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).

What is clinician rating scale?

Summary. In Parkinson's disease (PD), rating scales are used to assess the degree of disease-related disability and to titrate long-term treatment to each phase of the disease. Recognition of non-motor symptoms required modification of existing widely used scales to integrate non-motor elements.

How do you score the Zung Self Rating depression Scale?

Each item is scored on a Likert scale ranging from 1 to 4. A total score is derived by summing the individual item scores and ranges from 20 to 80. Most people with depression score between 50 and 69, while a score of 70 and above indicates severe depression.

What are the best treatments for bipolar disorder?

Depending on the severity and pattern of depressive episodes over time, health-care providers may offer psychological treatments such as behavioural activation, cognitive behavioural therapy and interpersonal psychotherapy, and/or antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Different medications are used for bipolar disorder. Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists. Antidepressants are not the first line of treatment for mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with extra caution.

How can community help prevent depression?

Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children.

How can we reduce depression?

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive coping in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for older persons can also be effective in depression prevention.

What is the WHO manual?

WHO has developed brief psychological intervention manuals for depression that may be delivered by lay workers to individuals and groups. An example is the Problem Management Plus manual, which describes the use of behavioural activation, stress management, problem solving treatment and strengthening social support. Moreover, the Group Interpersonal Therapy for Depression manual describes group treatment of depression. Finally, the Thinking Healthy manual covers the use of cognitive-behavioural therapy for perinatal depression.

What are the symptoms of bipolar disorder?

bipolar disorder, meaning that depressive episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour.

What is a mild depressive episode?

An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities but will probably not cease to function completely.

What is recurrent depressive disorder?

Recurrent depressive disorder: this disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment, and reduced energy leading to diminished activity for at least two weeks.

How long does it take to get diagnosed with depression?

To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.

How to treat depression?

In milder cases of depression, treatment might begin with psychotherapy alone, and medication added if the individual continues to experience symptoms. For moderate or severe depression, many mental health professionals recommend a combination of medication and therapy at the start of treatment.

What is it called when you feel sad?

Everyone feels sad or low sometimes, but these feelings usually pass with a little time. Depression (also called major depressive disorder or clinical depression) is different. It can cause severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

How long does it take for antidepressants to work?

Medications. Antidepressants are medications commonly used to treat depression. They take time to work—usually 4 to 8 weeks —and symptoms such as problems with sleep, appetite, or concentration often improve before mood lifts. It is important to give medication a chance before deciding whether or not it works.

How long does depression last?

Persistent depressive disorder (dysthymia), which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.

What are the symptoms of depression in children?

Children with depression may be anxious, cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children and teens with depression may get into trouble at school , sulk, be easily frustrated‚ feel restless, or have low self-esteem.

Why do older children have depression?

Older children and teens are more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia). In adolescence, females begin to experience depression more often than males, likely due to the biological, life cycle, and hormonal factors unique to women.

Why is rapport important in therapy?

In the first session, rapport was built with the patient in order to engage her in therapy and continue a smooth flow of therapy. Therapist actively listened the patient, gave unconditional positive regard and warm acceptance to patient which helped her to discuss her problems in comfort zone. Patient was talkative and easily explained her problems and daily routine activities in detail .

Why is psychoeducation important?

Psychoeducation was done with patient in order to make her aware about the severity and nature of her illness. She was educated about her role in therapy. Therapist guided the patient about treatment sessions and their duration which helped her to understand what to expect from the treatment sessions and how long the treatment might take. Therapist also guided her about collaborative work that she has a major role to do homework assignments at home which leads her improvement effectively (Appendix D2, a).

What is psychoeducation in psychology?

Psychoeducation. Psychoeducation refers to the process of providing education and information to patient about her illness, medication and psychological intervention. The patient was psychoeducated by providing insight about her problem and her role during therapy (Chamber & Pinnock, 2011).

Why did the patient give excuses in every session not to follow the techniques at home?

Patient gave excuses in every session not to follow the techniques at home due to having her persistent neck pain.

How old was the patient in the DSM V?

The patient was 33 years old, referred to trainee Clinical Psychologist at Psychiatry Department of Hospital, with the complaints of depressed mood, weeping spells, anger outburst, irritability, lack of interest in daily routine activities, loss of energy as well as low temperament, suicidal attempt, indecisiveness and disturbed sleep. According to DSM V, the patient was diagnosed with Major Depressive Disorder by meeting full diagnostic criteria of symptoms.

How many children did Patient have?

Patient had one daughter adopted by her brother. She was more attached with her daughter. Patient fulfilled her all demands and spent most of the time with her. Sometimes she became frustrated and used to get angry on her.

How old was Patient when she started school?

Patient started schooling at the age of 4 years. She was an average student and got average marks throughout her academic career. She did 10th standard with average marks then she did 12th from college. She had congenial relation with her teachers and class fellows. She also involved in extracurricular activities such as religious activities. After completing 12th standard, she left her studies due to her marriage.

What is the QIDS score?

The 16 items are scores on 4-point (0 to 3) ordinal scale. The QIDS total score includes only the highest scored item among the four items assessing sleep, the highest scored item of the four items assessing appetite and weight change, and the highest scored item of the two items assessing psychomotor retardation and agitation. As a result, the total QIDS score is calculated as a sum of nine items, one for each DSM-IV symptom, and ranges from 0 to 27. Higher scores describe more severe depression. QIDS-C has good psychometric properties in clinical populations and concurrent validity with established depression rating scales. [9,37]

What is the Montgomery-sberg Depression Rating Scale?

The Montgomery–Åsberg Depression Rating Scale (MADRS)is a 10-item clinician-rated scale assessing symptoms of depression that were selected to be responsive to treatment. [33] Sad mood is assessed by two items that capture the observer perspective and reported subjective experience, respectively. The other eight items assess tension, sleep, appetite, concentration, lassitude (activity), inability to feel (anhedonia), pessimism, and suicidal thoughts. Each item is rated on a 7-point (0 to 6) ordinal scale. A total score is computed as the sum of the 10 items and can range from 0 to 60. Higher scores reflect more severe depression. MADRS has been found to be internally consistent and to discriminate levels of depression severity more accurately than HRSD and other rating scales. [20,34,35]

What is the purpose of Star*D?

The primary purpose of STAR*D was to determine which treatments work best if the first antidepressant treatment does not produce remission. STAR*D included 4,041 treatment-seeking adult outpatients with DSM-IV nonpsychotic major depression, recruited in 31 centers in the United States. The treatment included protocol-guided citalopram 20 to 60 mg daily.[45] The assessment of depression severity comes from three sources: (1) the participants completed QIDS-SR at every treatment visit (baseline and follow-up every 2 weeks); (2) the treating clinician administered the QIDS-C at every treatment visit (baseline and follow-up visits every 2 weeks) based on a face-to-face interview; (3) an independent research outcome assessor (ROA) administered HRSD in telephone interviews at baseline and at study/level exit (end of treatment). This study uses 3,637 subjects with at least one postbaseline measurement during citalopram treatment (level 1) on any of the three outcome measures from the limited access data set (version no. 2) distributed by the National Institutes of Health (NIH). The numbers of subjects available for analyses differ depending on which outcome measure was used: valid postbaseline HRSD was available for 2,796 (69.2%), QIDS-C for 3,630 (89.8%), and QIDS-SR for 3,607 (89.3%) subjects. The STAR*D sample is described in Table 1and further details are available elsewhere. [45,46]The study was approved by institutional ethics review boards in participating centers. All participants provided a written consent after the procedures were explained. STAR*D is registered at ClinicalTrials.gov({"type":"clinical-trial","attrs":{"text":"NCT00021528","term_id":"NCT00021528"}}NCT00021528).

How strong is the correlation between the GENDEP scales?

At 0.77 (baseline) and 0.94 (exit), the correlation between the two clinician-rated scales was stronger than the correlation of either with the self-report BDI.

What is the Beck Depression Inventory?

The 21-item Beck Depression Inventory (BDI)was developed by J. Erbaugh based on records of statements made by individuals with depressive disorders during psychotherapeutic sessions. [11] Its 21-items assess all DSM-IV diagnostic symptoms of depression and additional symptoms (e.g. irritability). A large proportion of BDI items focus on the cognitive symptoms of depression, such as self-esteem, guilt, feeling disappointed in oneself, feeling of being punished, and pessimism. As a result, cognitive symptoms of depression contribute disproportionately to the BDI score.[20] Each item is composed of four first-person statements graded by the degree of depression severity it typically represents and rated on a 4-point ordinal scale (0 to 3). BDI was originally designed to be read out to the patient by an interviewer, but has commonly been used as self-report questionnaire for literate patients. The total BDI score is calculated by summing the 21 items and can range from 0 to 63. BDI has good psychometric properties with acceptable internal consistency and moderate concurrent validity. [15,20,23,38]

What scales are used to assess depression?

In most clinical trials, especially those of pharmacotherapy, depression severity has been assessed by trained clinicians using depression-rating scales, such as the Hamilton Rating Scale for Depression (HRSD) or the Montgomery–Åsberg Depression Rating Scale (MADRS). Current treatment guidelines and antidepressants drug licenses are largely based on treatment efficacy measured with these scales. However, use of clinician-rated scales in routine clinical practice is costly and puts additional requirements on clinicians' training and consultation times. It has therefore been suggested that cheaper self-report instruments may replace clinician-rating scales in routine practice. [8–10]Self-report instruments have a long tradition, especially in psychotherapy research, with the Beck Depression Inventory (BDI) being the most widely used questionnaire. [11–13]However, the BDI differs from clinician-rated scales not just in the mode of administration, but also in terms of what symptoms are assessed. This has prompted the development of parallel self-report and clinician-rated scales with matching content to facilitate the translation of evidence between research studies and clinical practice. [9,14,15]

What is the Hamilton scale for depression?

The 17-item Hamilton Rating Scale for Depression (HRSD)is a clinician-rated scale designed to measure the severity of illness in patients diagnosed with a depressive disorder.[30] The 17 items assess mood, guilt, suicidal thoughts, early insomnia, middle insomnia, late insomnia, activity, psychomotor retardation, agitation, psychic anxiety, somatic anxiety, appetite, fatigue, libido, hypochondriasis, weight loss, and insight. Nine items are scored on a 5-point (0 to 4) ordinal scale and eight items are scored on a 3-point (0, 1, 2) scale. A total score is calculated as sum of the 17 items and can range from 0 to 52. Higher scores reflect more severe depression. The relatively large number of items assessing sleep, appetite, weight loss, libido, and fatigue mean that somatic and neurovegetative symptoms contribute disproportionately to the total score. [20,22]HRSD is the most widely used depression rating scale. It has overall acceptable reliability, although several of its items are unreliable and add little to the measurement of depression severity. [31,32]

What is the prevalence of major depressive disorder?

The lifetime prevalence of the major depressive disorder in the United States is about 16% (Amanda et al. 2009). The study endorsed at least two current symptoms of depression found that current major depressive disorder was present in 66% cases. The annual prevalence rate is up to 25% in the patient with the chronic medical illness. Risk factors are multifactorial and include genetics, medical, social and environmental factors. Initial patient presentation of major depression can be a variety of physical symptoms including a headache, musculoskeletal pain, abdominal/pelvic pain, mood symptoms and cognitive changes. Depression is highly recurrent. In a study conducted by Bentley, Pagalilauan & Simpson (2014), of 200 patients who have recovered from an episode of major depressive disorder, 64% experienced at least one additional of major depression with the risk of recurrence in the first month after recovery. A history of the most predictive factor for additional episodes of major depressive disorder and each increase the risk of experiencing another by 16%.

Why did a 16 year old cut her wrists?

Psychiatric History: Patient reports that when she was 16 years old, she cut her wrists because of a relationship with her boyfriend. The relationship ended because she moved to another state. She admitted it was an unwise decision when she was taken to the hospital for treatment, but she was not hospitalized. There is no history of psychiatric hospitalization. At about 17 years old, she saw a psychologist briefly due to some issues in her life that were not fully revealed by the patient. She has used Cymbalta up to 60 mg and Wellbutrin up to 200 mg twice daily at various times. The Cymbalta was slightly helpful; following patient medication was changed to Wellbutrin by another physician to reduce her cigarette craving. She reports that the depression has been poorly controlled, but tobacco usage has been tapered down. She denies any treatment with a psychiatrist or psychiatric nurse practitioner.

What is the history of present illness?

The history of present illness supports a determination of the Major depressive disorder. The DSM-V criteria were met in the above patient demography. Further discussion will be presented in the differential diagnosis section. Patient exhibit some anxiety, as she mentioned of being anxious and stress. The patient goes into panic attack due to inability to pay her bills, and husband is also jobless. Other support measures will be further. Treatment measures will address depression and anxiety, and the family situation will be considered. Folk, J. (2017, April 25).

How old was the patient when she started walking?

The patient was born by a healthy pregnancy, reported by the best of her ability. She started walking without assistance at 12 months old. Patient has no evidence of developmental delays or issue from birth. The patient was born in the southern part of the country; patient has past young adulthood still her mental health problems are affecting her ability to secure a job, which is a primary developmental focus. Functional impairment is common in depression; this may persist more than symptoms. It needs to be assessed. (Culpepper, 2016)

What is the patient's background?

They moved here to stay with family members but had to be evicted because the house was sold. She has a 10-year-old daughter and 7-year-old twins (a boy and a girl). She got married 11 years ago and presently seeking employment with Safeway supermarket. She has an upcoming interview next week. She is of the Catholic faith , but only occasionally attends church. She and her family have had some difficulties with their church of choice. At one point, the pastor accused her husband of theft of his laptop computer and a credit card; even though, it was later shed to light that one of the young people in the church had been the culprit and no apology was ever given to her husband. Again, both couples were assisting their pastor on a yard sale, the proceeds from the yard sales were stolen, including some discount cards, the patient husband was accursed again, but the thief was later discovered. Still the church never apologizes for the false accusation.

How many people have anxiety disorders?

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. Anxiety disorders are highly treatable, yet only 36.9% of those suffering receive treatment. Folk, J. (2017, April 25).

Why does a patient go into panic attack?

The patient goes into panic attack due to inability to pay her bills, and husband is also jobless. Other support measures will be further. Treatment measures will address depression and anxiety, and the family situation will be considered.

What is the Montgomery-sberg Depression Rating Scale?

The 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) measures severity of depression in individuals 18 years and older. Each item is rated on a 7-point scale. The scale is an adaptation of the Hamilton Depression Rating Scale and has a greater sensitivity to change over time. The scale can be completed in 20 to 30 minutes.

How long does it take to complete the Beck Depression Inventory?

The inventory contains 21 self-report items which individuals complete using multiple choice response formats. The BDI takes approximately 10 minutes to complete. Validity and reliability of the BDI has been tested across populations, worldwide.

How long does it take to complete a child behavior questionnaire?

It takes parents five to 10 minutes to complete the questionnaire. Additional versions are available, including the Teacher’s Report Form and Youth Self-Report (from age 11). The CBCL has been translated into various languages.

Why do clinicians review evidence based literature?

Clinicians are encouraged to review the evidence-based literature about these assessments, especially regarding their intended use and appropriate populations, in order to determine which tools are best suited for their patients and practices.

Why is careful assessment important?

Careful assessment is an important part of evidence-based practice . Initial assessments of depressive symptoms can help determine possible treatment options, and periodic assessment throughout care can guide treatment and gauge progress. Many of the instruments described below were used in the studies that served as the evidence base ...

Overview

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Symptoms and Patterns

Diagnosis and Treatment

Who Response

References

Session Report

Case Summary

Source and Reason For Referral

• The patient came to Psychiatry Department of Hospital, with the complaints of depressed mood, weeping spells, anger outburst, irritability, muscle tension as well as lack of interest in daily routine activities and disturbed sleep. The patient was referred to trainee Clinical Psychologist for the assessment and management.

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History of Present Illness

Background Information

Preliminary Assessment

Informal Assessment

Formal Assessment

Visual Analogue

Diagnosis