TY  - CHAP
M1  - Book, Section
TI  - Assessment of Depression in Patients with Medical Illnesses
A1  - Wolfe, David
A1  - Erb, Jane
A1  - Biswas, Jhilam
A2  - Barsky, Arthur J.
A2  - Silbersweig, David A.
A2  - Boland, Robert J.
Y1  - 2016
N1  - 
T2  - Depression in Medical Illness
AB  - Like  most  medical  complaints,  a  depressed  mood  in  and  of  itself  represents  a  symptom,  and  not  a  diagnosis.  Indeed,  depression  is  a  relatively  nonspecific  complaint,  that  could  reflect  anything  from  the  most  debilitating  psychiatric  illness  to  a  normal  response  to  stress  or  loss  (Fig.  3-1).  The  differential  diagnosis  for  depression  among  psychiatric  disorders  alone  is  broad,  requiring  a  thorough  history,  examination,  and  often  laboratory  tests  to  discern  the  underlying  etiology  (or  at  least  exclude  potential  confounders).  The  assessment  of  mood  disorders  in  the  medically  ill  poses  yet  several  additional  challenges,  especially  since  many  core,  neurovegetative  symptoms  of  depression  –  such  as  fatigue,  anergia,  insomnia,  anorexia,  weight  loss,  and  pain  –  often  result  directly  from  medical  illnesses,  themselves.  Among  patients  with  severe  medical  disease,  assessment  can  be  confounded  by  “sickness  behavior,”  a  state  of  decreased  motivation  resulting  from  systemic  inflammation,  and  characterized  by  malaise,  anorexia,  insomnia,  fatigue,  as  well  as  fever.1  Similarly,  delirium,  especially  the  hypoactive  subtype,  can  present  with  prominent  mood  symptoms,  making  patients  appear  dysphoric.  Adding  to  the  complexity  in  assessment,  many  commonly  used  treatments,  such  as  steroids  or  interferon-α,  can  also  lower  mood  as  a  side  effect.  Proper  diagnosis  remains  critical,  as  the  recommended  treatment  approaches  do  vary  widely,  depending  on  the  etiology.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - neurology.mhmedical.com/content.aspx?aid=1138124349
ER  -