Depression (differential diagnoses)

About: Depression (differential diagnoses) is a research topic. Over the lifetime, 56557 publications have been published within this topic receiving 2048357 citations.

Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses

Abstract: Background: Cross-sectional studies have found that depression is uniquely associated with limitations in wellbeing and functioning that were equal to or greater than those of chronic general medical conditions such as diabetes and arthritis. However, whether these relative limitations persist over time is not known. Methods: We conducted a 2-year observational study of 1790 adult outpatients with depression, diabetes, hypertension, recent myocardial infarction, and/or congestive heart failure. Change in functional status and wellbeing was compared for depressed patients vs patients with chronic general medical illnesses, controlling statistically for medical comorbidity, sociodemographics, system, and specialty of care. Results: Over 2 years of follow-up, limitations in functioning and well-being improved somewhat for depressed patients; even so, at the end of 2 years, these limitations were similar to or worse than those attributed to chronic medical illnesses. Similar patterns were observed for depressed patients in the mental health specialty sector and those in the general medical sector, but the patients in the mental health specialty sector improved more. More severely depressed patients improved more in functioning, but even initially depressed patients without depressive disorder had substantial persistent limitations. Conclusion: Depressed patients have substantial and long-lasting decrements in multiple domains of functioning and well-being that equal or exceed those of patients with chronic medical illnesses.

Diagnosis and Treatment of Depression in Late Life

Abstract: DEPRESSION in the aging and the aged is a major public health problem. It causes suffering to many who go undiagnosed, and it burdens families and institutions providing care for the elderly by disabling those who might otherwise be able-bodied. What makes depression in the elderly so insidious is that neither the victim nor the health care provider may recognize its symptoms in the context of the multiple physical problems of many elderly people. Depressed mood, the typical signature of depression, may be less prominent than other depressive symptoms such as loss of appetite, sleeplessness, anergia, and loss of interest in, and enjoyment of, the normal pursuits of life. There is a wide spectrum of depressive symptoms as well as types of available therapies. Because of the many physical illnesses and social and economic problems of the elderly, individual health care providers often conclude that depression is a normal consequence

Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis.

Abstract: Importance Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies. Objective To provide a summary estimate of depression or depressive symptom prevalence among resident physicians. Data Sources and Study Selection Systematic search of EMBASE, ERIC, MEDLINE, and PsycINFO for studies with information on the prevalence of depression or depressive symptoms among resident physicians published between January 1963 and September 2015. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used a validated method to assess for depression or depressive symptoms. Data Extraction and Synthesis Information on study characteristics and depression or depressive symptom prevalence was extracted independently by 2 trained investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression. Main Outcomes and Measures Point or period prevalence of depression or depressive symptoms as assessed by structured interview or validated questionnaire. Results Data were extracted from 31 cross-sectional studies (9447 individuals) and 23 longitudinal studies (8113 individuals). Three studies used clinical interviews and 51 used self-report instruments. The overall pooled prevalence of depression or depressive symptoms was 28.8% (4969/17 560 individuals, 95% CI, 25.3%-32.5%), with high between-study heterogeneity ( Q = 1247, τ 2 = 0.39, I2 = 95.8%, P Q = 14.4, τ 2 = 0.04, I2 = 79.2%) to 43.2% for the 2-item PRIME-MD (1349/2891 individuals, 95% CI, 37.6%-49.0%, Q = 45.6, τ 2 = 0.09, I2 = 84.6%). There was an increased prevalence with increasing calendar year (slope = 0.5% increase per year, adjusted for assessment modality; 95% CI, 0.03%-0.9%, P = .04). In a secondary analysis of 7 longitudinal studies, the median absolute increase in depressive symptoms with the onset of residency training was 15.8% (range, 0.3%-26.3%; relative risk, 4.5). No statistically significant differences were observed between cross-sectional vs longitudinal studies, studies of only interns vs only upper-level residents, or studies of nonsurgical vs both nonsurgical and surgical residents. Conclusions and Relevance In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among resident physicians was 28.8%, ranging from 20.9% to 43.2% depending on the instrument used, and increased with calendar year. Further research is needed to identify effective strategies for preventing and treating depression among physicians in training.

Epidemiology of insomnia, depression, and anxiety

Abstract: Study objectives This study used empirically validated insomnia diagnostic criteria to compare depression and anxiety in people with insomnia and people not having insomnia. We also explored which specific sleep variables were significantly related to depression and anxiety. Finally, we compared depression and anxiety in (1) different insomnia types, (2) Caucasians and African Americans, and (3) genders. All analyses controlled for health variables, demographics, organic sleep disorders, and symptoms of organic sleep disorders. Design Cross-sectional and retrospective. Participants Community-based sample (N=772) of at least 50 men and 50 women in each 10-year age bracket from 20 to more than 89 years old. Measurements Self-report measures of health, sleep, depression, and anxiety. Results People with insomnia had greater depression and anxiety levels than people not having insomnia and were 9.82 and 17.35 times as likely to have clinically significant depression and anxiety, respectively. Increased insomnia frequency was related to increased depression and anxiety, and increased number of awakenings was also related to increased depression. These were the only 2 sleep variables significantly related to depression and anxiety. People with combined insomnia (ie, both onset and maintenance insomnia) had greater depression than did people with onset, maintenance, or mixed insomnia. There were no differences between other insomnia types. African Americans were 3.43 and 4.8 times more likely to have clinically significant depression and anxiety than Caucasians, respectively. Women had higher levels of depression than men. Conclusion These results reaffirm the close relationship of insomnia, depression, and anxiety, after rigorously controlling for other potential explanations for the relationship.