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Sufficient duration of symptoms, but does not have the required number of symptoms
0%
0/8
Insufficient duration of symptoms, but does have appropriate number of symptoms
12%
1/8
Sufficient duration and number of symptoms
Insufficient duration and number of symptoms
88%
7/8
The patient could not meet criteria for this disease without suicidal ideation
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This patient only has 3 of the 5 required symptoms for diagnosis. Her symptoms of ten days are 4 days short of meeting criteria for duration. Major depressive disorder is defined as episodes characterized by at least 5 of the following 9 symptoms for 2 or more weeks, one of which must be depressed mood or anhedonia: sleep disturbance, loss of interest in things that usually give the patient pleasure (anhedonia), guilt or worthlessness, low energy, decreased concentration, appetite and weight changes, psychomotor retardation or agitation, suicidal ideation, and depressed mood. They can be remembered by the pneumonic "SIG E CAPS." Major depressive disorder episodes often last 6-12 months. The duration of this patients symptoms (ten days) does not meet criteria, and she only has three of the nine listed symptoms. Osvath discusses current treatment of depression and agitation in the elderly. Clinical studies and practice indicate that trazodone is particularly effective in the treatment of depression accompanied by severe insomnia and anxiety. Due to its anxiolytic and sleep normalizing effects, trazodone is useful both in depression in the elderly and in the case of depression with dementia or severe agitation. Maurer discusses screening for depression. In the U.S., depression affects up to 9% of patients. The U.S. Preventative Services task Force recommends screening in adolescents and adults regularly in clinical practice. The Patient Health Questionnaire PHQ-2 and PHQ-9 are commonly used and validated screening tools with high sensitivity. Incorrect Answers: Answers 1-3: The patient does not meet criteria for duration (2 weeks) and is one symptom short of the 5 required symptoms for diagnosis. Answer 5: Suicidal ideation is not required for diagnosis of major depressive disorder.
2.5
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