Depression

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1. Explain why the clinical diagnosis of depression is difficult.

2. Describe the disturbances of mood, vegetative signs and cognitive changes that signal the presence of clinical depression.

3. Explain why a review of current medical, social and family history is important in the assessment and management of depression.

4. List an instrument which might be used to measure the severity of depression.

5. Identify features of depression that would suggest that a patient best be referred to a psychiatrist or be hospitalized.

6. List clinical guidelines used in the selection of tricyclics, serotonin re-uptake inhibitors, lithium salts and MAO inhibitors (newer antidepressants Serzone, Effexor and Remeron).

7. Identify common patient concerns regarding antidepressant therapy and discuss how these concerns may affect compliance.

8. Identify how office physicians monitor response to and determine length of antidepressant therapy.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 92, Pages 637-645

Essentials of Family Medicine, Chapter 48, pages 733-744

“Antidepressants: Update on New Agents and Indications” Adrienne Z. Ables, Pharm.D., and Otis L. Baughman, III, M.D., Spartanburg Family Medicine Residency Program, Spartanburg, SC, American Family Physician, February 1, 2003.

"Childhood and Adolescent Depression" Shashi K. Bhatia, M.D. and Subhash C. Bhatia, M.D., Creighton University, Department of Psychiatry, Omaha, NE, American Family Physician, January 1, 2007.