🏨This woman most likely has major depression. Before a person can be diagnosed with depression, they MUST have 5 or more of the following features continuously for at least 2 weeks:
M- Mood (depressed)
I- loss of INTEREST
P- Psychomotor retardation
A- Anhedonia ( diminished interest or pleasure in all or almost all activities)
S- Suicidal ideation
S- Poor sleep
E- Reduced Energy
C- Loss of concentration
G- Feelings of guilt or worthlessness
The mnemonic is MI PASS ECG, some people use SIGE CAPS to remember the features.
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📌If these features are present for 2 years or more, the diagnosis becomes DYSTHYMIA.
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📗Some medical conditions can mimic depression, so in testing these patients, it is good to order Serum B12, urine toxicology, TSH to screen for hypothyroidism and RPR to screen for syphilis.
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🖍When a diagnosis of depression is made, knowing if the patient is a candidate for admission or outpatient treatment is determined by how likely they are to commit suicide. You may screen for this using the mnemonic SAD PERSONS. A score above 8 probably requires hospital admission. You may also use your discretion and admit involuntarily if the patient is uncooperative and a risk to himself or others.
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👨🏽⚕️Regular clinic visits, cognitive-behavioral therapy (CBT) and medication such as Selective serotonin reuptake inhibitors (SSRIs) are important in managing depression. Other classes of antidepressants may be used depending on the patient and side-effects
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