Abstract
Depression is characterized by symptoms that generally fall into two categories: psychological, and somatic or physical. The former are characterized by a persistent sense of sadness, termed “dysphoria,” and a persistent state of lack of usual enjoyment or pleasure in previously pleasurable activities, termed “anhedonia.” Depressed individuals with dysphoria describe themselves as being helpless and hopeless, discouraged, “blue,” “fed up,” or “down in the dumps” and “useless.” They are often easily tearful, irritable, or frustrated because they tend to have negatively biased perceptions about themselves and others to whom they relate, and a pessimistic view of their future, often manifesting as inappropriate guilt. The most serious symptom of depression with respect to mortality and morbidity is suicidal behavior [1]. The most benign type of suicidal thinking — that “life is not worth living” — is consonant with beliefs by individuals that their lives are hopeless, they are helpless and worthless, and have no chance for future betterment. Suicidal thinking around plans to harm oneself (or others) indicates a higher level of potential risk, which is greatest when the individual is contemplating acting on the plans or has demonstrated behavior in furtherance of the suicidal thinking.Proximal risk factors for suicide include agitation, current suicidal intent or plan, severe depression and/ or anhedonia, instability (e.g., alcohol abuse or decline in health), recent loss, and availability of a lethal agent.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Rihmer Z. Suicide risk in mood disorders. Curr Opin Psychiatry 2007; 20:17–22.
Hawton K, Harriss L. Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital. J Clin Psychiatry 2007; 68:1574–1583.
Preskorn SH. Outpatient Management of Depression: A Guide for the Practitioner, 2nd edition. Caddo, OK: Professional Communications Inc, 1999.
Yates WR, Mitchell J, Rush AJ. Clinical features of depressed outpatients with and without co-occurring general medical conditions in STAR*D. Gen Hosp Psych 2004; 26:421–429.
Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-item Quick Inventory of Depressive Symptomatology (QIDS), clinician rated (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry 2003; 54:804–814.
Trivedi, MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression. Using measurement-based care in STAR*D: Implications for clinical practice. Am J Psychiatry 2006; 163:1–13.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive status of patients for the clinician. J Psychiatr Res 1975; 12:189–198.
Rights and permissions
Copyright information
© 2009 Current Medicine Group Ltd, a part of Springer Science+Business Media
About this chapter
Cite this chapter
Friedman, E.S. (2009). Diagnosis. In: Handbook of Depression. Springer, Tarporley. https://doi.org/10.1007/978-1-907673-24-5_3
Download citation
DOI: https://doi.org/10.1007/978-1-907673-24-5_3
Publisher Name: Springer, Tarporley
Print ISBN: 978-1-908517-24-1
Online ISBN: 978-1-907673-24-5
eBook Packages: MedicineMedicine (R0)