Depression
1. What are the salient historical features of the case?
The main noticeable historical features of the case include the patient’s depressed mood, described sleep disturbance, diminished interest in certain activities, feeling of guilt, suicidal thoughts, and reduced energy and concentration. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for major depressive disorder, a patient must present at least 5 of the symptoms mentioned above for at least 2 weeks and 1 of the symptoms must include anhedonia or depressed mood (Ottesen, 2013). Furthermore, the symptoms of depression cannot not be attributable to other psychological/ psychotic disorders such as, schizoaffective disorder, delusional disorder, or mania. The DSM-5 further categorizes depressive disorder as mild, moderate, or severe, with partial or full remission (Ottesen, 2013). In most patients, depressive symptoms cause substantial distress and impairment in social and occupational functioning. It is important to distinguish normal grief from a major depressive disorder.
2. What physical examination is appropriate to the diagnosis?
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There are not any specific physical findings for major depressive disorder. Nonetheless, a comprehensive mental health evaluation must include a thorough medical evaluation to rule out organic causes. The most common medical causes that mimic the symptoms of depressive disorder fall into the following major categories; infectious, neoplastic, neurologic, medication related, and endocrine disorders (Sacher et al., 2012). It is imperative to identify any neurologic, endocrine, or infectious symptoms that may reveal an underlying physiologic cause of depression. For example, physical examination of the thyroid may reveal enlargement and the possibility of an autoimmune thyroid