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Medical history, your current and past these abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia because of the multifactorial nature.

25.04.2015

Depressive symptoms scale, tinnitus cure - For You

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The Brief Scale to Detect Hearing Loss Screener is based on the National Health and Nutritional Examination Survey (NHANES). There are many causes of unintentional weight loss, including acute infections, depression, drugs (eg, chemotherapeutic agents, laxatives, thyroid medications, and amphetamines), conditions that prevent food consumption (eg, painful mouth sores, newly applied orthodontic appliances, loss of teeth), loss of appetite, malignancy, smoking, and AIDS.
Many of the symptoms of depression, such as appetite change, weight loss, and loss of energy, are similar to cancer symptoms.[44] Depressed patients with cancer may be at higher risk of suicide.
Patient information: See related handout on postpartum depression, written by the authors of this article.
Risk of postpartum depressive symptoms with elevated corticotropin- releasing hormone in human pregnancy.
Validation of the Edinburgh Postnatal Depression Scale (EPDS) in a sample of women with high-risk pregnancies in France. Identifying depression in the first postpartum year: guidelines for office-based screening and referral. Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum.
A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Prevention and treatment of post-partum depression: a controlled randomized study on women at risk. A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression. A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression. Edinburgh Postnatal Depression ScalePhysician instructions: Have the patient complete the scale by marking one answer for each question that comes closest to how she has felt in the past seven days, not just how she feels today. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses.
National Institute of Mental Health treatment of Depression Collaborative Research Program.
Symptom profiles of depression among general medical service users compared with specialty mental health service users. Summary of the practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Development and validation of a geriatric depression screening scale: a preliminary report. First, cancer patients frequently have fatigue, dizziness, dehydration, or other symptoms that increase the likelihood of a fall. 34 Psychotherapy can also be used as adjunct therapy with medication in moderate to severe postpartum major depression. A thorough risk-benefit discussion with each patient is essential before deciding on treatment for postpartum major depression. Primary care physicians, not mental health professionals, treat the majority of patients with symptoms of depression.


Preventive Services Task Force (USPSTF) recently reviewed new evidence finding that patients fared best when physicians recognized the symptoms of depression and made sure that they received appropriate treatment.8 Based on this evidence, the USPSTF issued new depression screening recommendations last May, encouraging primary care physicians to routinely screen their adult patients for depression. Although each measure has a unique scoring system, higher scores consistently reflect more severe symptoms. Signs of depression that are more common in the elderly than in other populations include diminished self-care, irritability, and psychomotor retardation.
Geriatric Depression Scale–Short FormReprinted with permission from Sheikh JI, Yesavage JA. Finally, the diagnosis and treatment of cancer can contribute to depression in family caregivers, possibly limiting their ability to provide support for the cancer patient. Some women with postpartum major depression may experience suicidal ideation or obsessive thoughts of harming their infants, but they are reluctant to volunteer this information unless asked directly.
Persons who are depressed have feelings of sadness, loneliness, irritability, worthlessness, hopelessness, agitation, and guilt that may be accompanied by an array of physical symptoms. All measures have a statistically predetermined cutoff score at which depression symptoms are considered significant.
Early diagnosis and treatment of depression in the elderly improve quality of life and functional status, and may help prevent premature death.When using screening instruments with elderly patients, it is important to consider their level of cognitive impairment along with visual deficits. Once depression is diagnosed and treatment is initiated, repeated administration of these measures provides an excellent means of tracking response to pharmacotherapy or psychotherapy.Depression measures should be selected based on the patient population (Table 4).
These factors include depression, smoking and alcohol use, dysphagia, mucositis, changes in taste and smell, difficulty chewing, the inability to shop or cook, and the side effects of medication.
The Pediatric Symptom Checklist may serve as a general psychosocial screen for children and adolescents. In patients with moderate to severe postpartum major depression, psychotherapy may be used as an adjunct to medication. Identifying patients with depression can be difficult in busy primary care settings where time is limited, but certain depression screening measures may help physicians diagnose the disorder. An interview is necessary because many conditions have symptoms that are common to depression.
The Edinbugh Postnatal Depression Scale may be photocopied by individual researchers or clinicians for their own use without seeking permission from the publishers. Patients who score above the predetermined cut-off levels on the screening measures should be interviewed more specifically for a diagnosis of a depressive disorder and treated within the primary care physician's scope of practice or referred to a mental health subspecialist as clinically indicated.
In addition, screening measures do not address important diagnostic features such as duration of symptoms, degree of impairment, and comorbid psychiatric disorders.
Edinburgh Postnatal Depression ScaleReprinted with permission from Cox JL, Chapman G, Murray D, Jones P.
In postpartum women, the Edinburgh Postnatal Depression Scale is the preferred measure.The use of depression screening measures in elderly patients varies with their cognitive status and clinical presentation.
The scale must be copied in full and all copies must acknowledge the following source: Cox JL, Holden JM, Sagovsky R. Symptoms include brief crying spells, irritability, poor sleep, nervousness, and emotional reactivity. Targeted screening in high-risk patients such as those with chronic diseases, pain, unexplained symptoms, stressful home environments, or social isolation, and those who are postnatal or elderly may provide an alternative approach to identifying patients with depression.
An evaluation is critical in ruling out conditions that may present with symptoms of depression, such as hypothyroidism and pancreatic cancer.


In cognitively intact patients older than 65 years, the GDS or one-item screen are currently the preferred instrument because the psychometric data on the BDI and CES-D are mixed in this population.44In patients who have cognitive deficits, interviewer-administered instruments such as the Cornell Scale for Depression in Dementia (Figure 4)24 or the Hamilton Rating Scale for Depression45 are preferred. Use of the GDS is limited to cognitively intact or mildly impaired elderly patients and interviewer-administered instruments, such as the Cornell Scale for Depression in Dementia or the Hamilton Rating Scale, are preferable when cognitive deficits are present.
If left untreated, postpartum major depression can lead to poor mother-infant bonding, delays in infant growth and development, and an increased risk of anxiety or depressive symptoms in the infant later in life. However, older patients with depression may also present with unexplained somatic symptoms and may deny sadness or loss of pleasure. It manifests as a combination of feelings of sadness, loneliness, irritability, worthlessness, hopelessness, agitation, and guilt, accompanied by an array of physical symptoms (Table 1).6 Recognizing depression in patients in a primary care setting may be particularly challenging because patients, especially men, rarely spontaneously describe emotional difficulties. The strongest risk factor is a history of postpartum major depression with a previous pregnancy. Decreased energy and disrupted sleep related to infant care may be difficult to differentiate from symptoms of depression. If the patient has previously responded well to a specific agent, that medication should be the first choice unless there is evidence of potential harm.16,44 Although breastfed infants are unlikely to experience adverse effects from antidepressant medications, infants should be monitored for symptoms, such as persistent irritability, decreased feeding, or poor weight gain. Written permission must be obatined from the Royal College of Psychiatrists for copying and distribution to others or for republication (in print, online or by any other medium).Translations of the scale, and guidance as to its use, may be found in Cox JL, Holden J.
It is important to discuss symptoms, such as obsessive thoughts and suicidal ideation, with these women. Maternal depression or problems within the mother-infant dyad can also be associated with these symptoms.45,46 Formula feeding should be considered in women with severe postpartum major depression that requires medication implicated in adverse effects for the infant.
Up to 60 percent of women with postpartum major depression have obsessive thoughts focusing on aggression toward the infant.29 These thoughts are intrusive and similar to those in obsessive-compulsive disorder. After symptoms are in remission, treatment is typically continued for six to nine months of euthymia before tapering the medication.
The shame and guilt associated with these intrusive images or thoughts can reduce the likelihood of divulging this symptom. Tapering over two weeks, especially for paroxetine, extended-release venlafaxine (Effexor XR), and extended-release desvenlafaxine (Pristiq), can prevent the influenza-like symptoms of discontinuation syndrome.Estrogen therapy has been studied as a treatment for postpartum major depression. Physicians should ask about these symptoms as part of the diagnosis of postpartum major depression.
Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity. However, women with mild to moderate postpartum major depression may have passive suicidal ideation, defined as a desire to die but no plan. The scale will not detect mothers with anxiety neuroses, phobias or personality disorders.Women with postpartum depression need not feel alone. However, as depression worsens, she may view herself as a bad mother and believe that her child would be better off without her.




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