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Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 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. Treating depressed primary care patients improves their physical, mental, and social functioning. 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. JavaScript is currently disabled, this site works much better if you enable JavaScript in your browser. This site copyright ©2016 The Trustees of Columbia University in the City of New York, for its National Center for Children in Poverty (NCCP). 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. This paper discusses some of the methodological problems related to the articulation of such a theory, and goes on to outline a theory of adolescent development that is consistent with the tenets of self psychology. Mortality Reports Database, Web-based Injury Statistics Query and Reporting System (WISQARS), National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Number of Accredited Programs for the Current Academic Year (2009-2010), Accreditation Council for Graduate Medical Education.
Training Opportunities in Adolescent Medicine – 2010, The Society for Adolescent Medicine.
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). The major points made are: Adolescence does not represent a recapitulation of prior phase of development, the sense of self cohesion is fundamental to a healthy sense of self, and the culmination of the adolescent process is the formation of a nuclear sense of self. The Center for Injury Research and Prevention at the Children’s Hospital of Philadelphia. The validity of certain depression screening instruments is significantly decreased in patients with a Mini-Mental State Examination score of 15 or less.42A  Table 2 includes information on the BDI, CES-D, and Geriatric Depression Scale (GDS)22 specific to their use in persons older than 60 years. The Pediatric Symptom Checklist may serve as a general psychosocial screen for children and adolescents.
Developmental psychology and explanatory theory in psychoanalysis.The annual of psychoanalysis. Partner Violence Among Adolescents in Opposite-sex Romantic Relationships: Findings From the National Longitudinal Study of Adolescent Health. Total Population and Uninsured Persons Under Age 65: Percent by Selected Population Characteristics, United States, First Half of 2005 (Table 1).
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 GDS is unique in that it was specifically developed for use in geriatric patients, and it contains fewer somatic items. In adult patient populations, screening with the BDI, CES-D, or Zung measures is recommended in targeted, high-risk populations.
Program Committee for a Workshop on the Synthesis of Research on Adolescent Health and Development, Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Criminal Victimization in the United States: Victimization Rates for Persons Age 12 and Over, By Type of Crime and Age of Victims.
Criminal Victimization in the United States: Number, Percent Distribution, and Rate of Victimizations, By Type of Crime.
Testimony before Homeland Security Subcommittee on Emergency Preparedness, Science and Technology. 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.


Availability of Pediatric Services and Equipment in Emergency Departments: United States, 2002-03.
Graduated Driver Licensing in the United States: Evaluation Results from the Early Programs.
Graduated License Programs and Fatal Crashes of 16-year-old Drivers: A National Evaluation.
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.
The Study of Developmental Psychopathology in Adolescence: Integrating Affective Neuroscience with the Study of Context.
Behavior Change Counseling in the Emergency Department to Reduce Injury Risk: A Randomized, Controlled Trial. These instruments require more time to administer; however, they are more appropriate than self-report instruments for cognitively impaired patients. However, older patients with depression may also present with unexplained somatic symptoms and may deny sadness or loss of pleasure. Regulation of Firearm Dealers in the United States: An Analysis of State Law and Opportunities for Improvement.
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. A reconsideration of the therapeutic process in short term therapy from the vantage point of the self psychologist.
Remarks about the formation of the self—letter to a student regarding some principles of psychoanalytic research”. Self-object transference in the treatment of borderline neurocognitively impaired children.
Early adolescence: The center of the universe, an integration of Piagetian and self psychology theories. On the adolescent process as a transformation of the self.Journal of Youth and Adolescence, 257–272.



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