 Key features of depression and its management in general practice. |
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"..I'm not like other people.." |
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1. Fatima meets the ICD-PHC criteria for mild depression. |
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2. Fatima is likely to be suffering from an adjustment disorder. |
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3. An adjustment disorder may continue long after the initiating event has terminated. |
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4. An adjustment disorder usually leads to a general practice presentation. |
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5. People who suffer an adjustment disorder are at increased risk of major depression during that time. |
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1. Fatima meets the ICD-PHC criteria for mild depression.
Author's
answer: True
In
a primary care setting, where a milder spectrum of illness is encountered,
a more useful classification of depression is the ICD-10. This classification
is used throughout the world, and is derived in part from DSM-IV, and
does not attempt to impose minimum number of criteria for the diagnosis.
For each condition, diagnostic and management guidelines are given on
the opposite pages. A condensed version of ICD-10 is available for use
in primary care (ICD-PHC).
The
ICD-10 primary health care criteria (ICD-PHC) diagnostic features of depression
are as follows:
1. Low or sad mood
2. Loss of interest or pleasure
The following associated symptoms are frequently present:
1. Disturbed sleep
2. Guilt or loss of self-confidence
3. Fatigue or loss of energy
4. Agitation or slowing of movement or speech
5. Disturbed appetite
6. Suicidal thoughts or acts
7. Poor concentration
As Fatima's symptoms are relatively mild, she could be said to be suffering from mild depression. Mild depression appears in a variety of contexts and in other systems of classification is given a variety of names: sub-syndromal symptomatic depression, subclinical depression, subthreshold depression, minor depressive disorder, or adjustment disorder.