Depression - Revision history

Danbot: Add to Category:Symptoms - common EM chief complaint

2026-03-22T09:41:50Z

Add to Category:Symptoms - common EM chief complaint

← Older revision		Revision as of 09:41, 22 March 2026
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	<references/>		<references/>

			[[Category:Symptoms]]
	[[Category:Psychiatry]]		[[Category:Psychiatry]]

Danbot: Add PHQ9_Calculator to page

2026-03-21T16:32:01Z

Add PHQ9_Calculator to page

← Older revision		Revision as of 16:32, 21 March 2026
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	==See Also==		==See Also==
	*[[SAD PERSONS score]]		*[[SAD PERSONS score]]

			== Calculators ==
			{{PHQ9_Calculator}}

	==External Links==		==External Links==

Jonrako: /* Background */

2021-08-09T01:57:41Z

Background

← Older revision		Revision as of 01:57, 9 August 2021
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	==Background==		==Background==
	Depression is a risk factor for suicide, which is the leading cause of death among adolescents in the U.S.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>		*Depression is a risk factor for suicide, which is the leading cause of death among adolescents in the U.S.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>
	Depression in adolescence predicts depression & anxiety in adulthood and most affected adults had their first depressive episode during adolescence<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>		*Depression in adolescence predicts depression & anxiety in adulthood and most affected adults had their first depressive episode during adolescence<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>

	==Clinical Features==		==Clinical Features==

Jonrako at 01:56, 9 August 2021

2021-08-09T01:56:56Z

← Older revision		Revision as of 01:56, 9 August 2021
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	==Background==		==Background==
	~~Suicide~~ is the leading cause of death among adolescents in the U.S.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>		Depression is a risk factor for suicide, which is the leading cause of death among adolescents in the U.S.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>
	Depression in adolescence predicts depression & anxiety in adulthood and most affected adults had their first depressive episode during adolescence~~, highlighting the need for early identification and treatment.~~ <ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>		Depression in adolescence predicts depression & anxiety in adulthood and most affected adults had their first depressive episode during adolescence<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>

	==Clinical Features==		==Clinical Features==
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	*Consider consult with psychiatric team in other cases, particularly if severe symptoms and patient not already plugged into psych care		*Consider consult with psychiatric team in other cases, particularly if severe symptoms and patient not already plugged into psych care
	*Pharmacologic agents (typically not started in ED due to need for monitoring and adjustment)		*Pharmacologic agents (typically not started in ED due to need for monitoring and adjustment)
			**Antidepressants can take up to 8 weeks to reach maximum effect, so discuss expectations to ensure adherence.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>
	**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)		**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)
	**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)		**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)
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	**TCAs ([[amitriptyline]], clomipramine, desipramine, [[doxepin]], imipramine, [[nortriptyline]], trimipramine)		**TCAs ([[amitriptyline]], clomipramine, desipramine, [[doxepin]], imipramine, [[nortriptyline]], trimipramine)
	**MAOIs (isocarboxazid, phenelzine, selegiline)		**MAOIs (isocarboxazid, phenelzine, selegiline)
			*Cognitive Behavioral Therapy and Interpersonal psychotherapy have been shown to be effective in treating depression in adolescents.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>

	==Disposition==		==Disposition==
			*Those at risk for self-harm or harm to others should be admitted/transferred for psych evaluation.

	==See Also==		==See Also==

Jonrako: /* Background */

2021-08-09T01:45:05Z

Background

← Older revision		Revision as of 01:45, 9 August 2021
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	==Background==		==Background==
			Suicide is the leading cause of death among adolescents in the U.S.<ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>
			Depression in adolescence predicts depression & anxiety in adulthood and most affected adults had their first depressive episode during adolescence, highlighting the need for early identification and treatment. <ref>Miller, Leslie, and John V. Campo. “Depression in Adolescents.” New England Journal of Medicine, edited by Allan H. Ropper, vol. 385, no. 5, 2021, pp. 445–49. Crossref, doi:10.1056/nejmra2033475.</ref>

	==Clinical Features==		==Clinical Features==

ClaireLewis: /* Evaluation */

2019-10-10T17:01:08Z

Evaluation

← Older revision		Revision as of 17:01, 10 October 2019
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	==Evaluation==		==Evaluation==
	*Evaluate [[suicide risk]]		*Evaluate [[suicide\|suicide risk]]
	*Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5		*Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5
	{{General ED Psychiatric Workup}}		{{General ED Psychiatric Workup}}

ClaireLewis at 17:00, 10 October 2019

2019-10-10T17:00:54Z

← Older revision		Revision as of 17:00, 10 October 2019
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	**Appetite disturbance or weight loss		**Appetite disturbance or weight loss
	**Psychomotor retardation/agitation		**Psychomotor retardation/agitation
	**Suicidal thoughts		**[[suicide\|Suicidal thoughts]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5		*Evaluate [[suicide risk]]
			*Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5
	{{General ED Psychiatric Workup}}		{{General ED Psychiatric Workup}}

	==Management==		==Management==
	*~~Consult~~ with psychiatric team		*Psych consult or admission if high risk of [[suicide]]
	*~~Pharmocologic~~ agents (typically not started in ED due to need for monitoring and adjustment)		*Consider consult with psychiatric team in other cases, particularly if severe symptoms and patient not already plugged into psych care
			*Pharmacologic agents (typically not started in ED due to need for monitoring and adjustment)
	**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)		**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)
	**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)		**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)

Mholtz at 04:00, 3 June 2017

2017-06-03T04:00:40Z

← Older revision		Revision as of 04:00, 3 June 2017
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	==Background==		==Background==


	==Clinical Features==		==Clinical Features==
	Must have 5 of the following features ~~for major depressive disorder~~ for >2 wks<ref>American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.</ref>		Major Depressive Disorder (MDD) - Must have 5 of the following features for >2 wks<ref>American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.</ref>
	*Depressed mood or anhedonia (must be present)		*Depressed mood or anhedonia (must be present)
	*SIGECAPS		*SIGECAPS
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	==Management==		==Management==
	*Consult with psychiatric team		*Consult with psychiatric team
	*Pharmocologic agents, typically not started in ED due to need for monitoring and adjustment		*Pharmocologic agents (typically not started in ED due to need for monitoring and adjustment)
	**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)		**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)
	**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)		**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)
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	==Disposition==		==Disposition==
	*See [[Sad person's score]]

	==See Also==		==See Also==
			*[[SAD PERSONS score]]

	==External Links==		==External Links==

ClaireLewis: /* Management */

2017-03-28T18:22:03Z

Management

← Older revision		Revision as of 18:22, 28 March 2017
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	*Pharmocologic agents, typically not started in ED due to need for monitoring and adjustment		*Pharmocologic agents, typically not started in ED due to need for monitoring and adjustment
	**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)		**SSRIs (citalopram, fluoxetine, paroxetine, sertraline)
	**SNRIs (duloxetine, venlafaxine, milnacipran)		**SNRIs ([[duloxetine]], [[venlafaxine]], milnacipran)
	**Serotonin modulators (trazodone)		**Serotonin modulators ([[trazodone]])
	**Atypical (bupropion, ~~mirtazpine~~)		**Atypical ([[bupropion]], [[mirtazapine]])
	**TCAs (amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, trimipramine)		**TCAs ([[amitriptyline]], clomipramine, desipramine, [[doxepin]], imipramine, [[nortriptyline]], trimipramine)
	**MAOIs (isocarboxazid, phenelzine, selegiline)		**MAOIs (isocarboxazid, phenelzine, selegiline)

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T11:18:18Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 11:18, 23 July 2016
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	{{Psych DDX}}		{{Psych DDX}}

	==~~Diagnosis~~==		==Evaluation==
	Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5		Depression screening with PHQ-9, the PHQ-2, the Beck Depression Inventory for Primary Care, and the WHO-5
	{{General ED Psychiatric Workup}}		{{General ED Psychiatric Workup}}