The Pathophysiology Of Depression And Depression

1863 WordsMay 6, 20178 Pages
The pathophysiology of depression is multifaceted and difficult to pinpoint. Depression can arise from a multitude of precipitating factors, both external and internal to the patient. There are varying theories about the cause of depression, each of which “are based on studies investigating psychosocial stress and stress hormones, neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate and gamma-aminobutyric acid (GABA), neurocircuitry, neurotrophic factors, and circadian rhythms” (Hasler, 2010). Due to the vast immensity of theories available, Woo, & Robinson (2016) recommends that treatment for depression should be tailored to each patient and their disease state individually. In Mary Smith’s case her depression appears…show more content…
Mary is a strong candidate for depression screening and assessment, as well as several diagnostic tests to assess potential causes of her symptoms. These additional diagnostic tests would include: CBC, BMP, Vitamin D levels, LFTs, TSH, and T4. To rule out a physiological disease process. In 2016 the US Preventive Services Task Force (USPSTF) recommended that screening be completed within the general population for depression assessment. While the frequency of the screening was not specified, it was made clear that screening should be implemented with adequate systems in place to ensure diagnosis, treatment, and appropriate follow-up (Siu, Bibbins-Domingo, Grossman, Baumann, Davidson, Ebell & Krist, 2016). Of the available screening tools, the Patient Health Questionnaire (PHQ 9) is the most frequently used, and somewhat more accurate screening tool than the other screening tools available. A score greater than 10 would indicate a possible depressive disorder, in a scale of 0-27. The PHQ-9 includes questions about depressive symptoms impairing function, which is a key criteria in order to establish a DSM-based diagnosis of depression, and the PHQ-9 can be used to monitor response to treatment (Manea, Gilbody, & McMillan, 2015). A shortened version of the PHQ 9 is available and called PHQ2, this abbreviated version is
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