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Depression Guideline Panel. Depression in Primary Care: Detection and Diagnosis (Volume 1: Detection and Diagnosis). Rockville (MD): Agency for Health Care Policy and Research (AHCPR); 1993 Apr. (AHCPR Clinical Practice Guidelines, No. 5.1.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Depression in Primary Care: Detection and Diagnosis (Volume 1: Detection and Diagnosis)

Depression in Primary Care: Detection and Diagnosis (Volume 1: Detection and Diagnosis).

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  • Acute Treatment.
  • Formally defined procedures used to reduce and remove the signs and symptoms of depression and to restore psychosocial function.
  • Adequate Treatment
  • Analysis. Analysis of data in terms of the relationship between the number of patients who received a predetermined minimum amount of treatment and the number who responded.
  • Agoraphobia.
  • A disorder characterized by a fear of open, public places or of situations where crowds are found.
  • Anhedonia.
  • An absence of or the inability to experience a sense of pleasure from any activity.
  • Behavioral Therapy.
  • A form of psychotherapy that focuses on modifying observable problematic behaviors by systematic manipulation of the environment.
  • Bipolar Disorder.
  • A major mood disorder characterized by episodes of major depression and mania or hypomania, formerly called manic-depressive psychosis, circular type. The diagnosis of bipolar I disorder requires one or more episodes of mania. The diagnosis of bipolar II disorder requires one or more episodes of hypomania and is excluded by the history or presence of a manic episode. Current episode may be manic, depressed, hypomanic, or mixed manic type.
  • Clinical Management.
  • Education of and discussion with patients and, when appropriate, their families about the nature of depression, its course, and the relative costs and benefits of treatment options. It also includes assessment and management of the patient while in treatment, along with resolution of obstacles to treatment adherence, monitoring and management of treatment side effects, and assessment of outcome.
  • Cognitive Therapy.
  • A treatment method that focuses on revising a person's maladaptive processes of thinking, perceptions, attitudes and beliefs. Cognitive therapy has been developed for different specific disorders, including depression.
  • Completer Analysis.
  • Analysis of data in terms of the relationship between the number of patients whose condition improved and the number who completed the treatment protocol.
  • Continuation Treatment.
  • Treatment designed to prevent the return of the most recent mood episode.
  • Cyclothymic Disorder.
  • A mood disorder of at least 2 years' duration characterized by numerous periods of mild depressive symptoms not sufficient in duration or severity to meet criteria for major depressive episodes interspersed with periods of hypomania. Some view this condition as a mild variant of bipolar disorder.
  • Dementia.
  • A group of mental disorders involving a general loss of intellectual abilities, including memory, judgment, and abstract thinking. There may be associated poor impulse control and/or personality change. Dementias may be progressive, reversible, or static and have a variety of causes.
  • Dysthymia.
  • A mood disorder characterized by depressed mood and loss of interest or pleasure in customary activities, with some additional signs and symptoms of depression, that is present most of the time for at least 2 years. Many patients with dysthymia go on to develop major depressive episodes.
  • Electroconvulsive Therapy.
  • A treatment method usually reserved for very severe or psychotic depressions or manic states that often are not responsive to medication treatment. A low-voltage alternating current is sent to the brain to induce a convulsion or seizure, which accounts for the therapeutic effect.
  • Hypomania.
  • An episode of illness that resembles mania, but is less intense and less disabling. The state is characterized by a euphoric mood, unrealistic optimism, increased speech and activity, and a decreased need for sleep. For some, there is increased creativity, while others evidence poor judgment and impaired function.
  • Intent-to-Treat Analysis.
  • Analysis of data in terms of the relationship between the number of patients randomized to treatment and the number whose condition improved.
  • Interpersonal Psychotherapy.
  • A time-limited psychotherapeutic approach that aims at clarification and resolution of one or more of the following interpersonal difficulties: role disputes, social isolation, prolonged grief reaction, or role transition. The patient and therapist define the nature of the difficulty and work to its resolution.
  • Maintenance Treatment.
  • Treatment designed to prevent a new mood episode (e.g., depression, mania, hypomania).
  • Major Depressive Disorder.
  • A major mood disorder characterized by one (single) or more (recurrent) episodes of major depression, with or without full recovery between episodes.
  • Mania.
  • An episode of illness usually seen in the course of bipolar I disorder and characterized by hyperexcitability, euphoria, and hyperactivity. Rapid thinking and speaking, agitation, a decreased need for sleep, and a marked increase in energy are nearly always present. During manic episodes, some patients also experience hallucinations or delusions. Manic episodes can also be caused by selected general medical disorders.
  • Melancholic Features.
  • Symptoms usually found in severe major depressive episodes, including marked loss of pleasure, psychomotor retardation or agitation, weight loss, and insomnia.
  • Mood Disorders.
  • A grouping of psychiatric conditions that have as a central feature a disturbance in mood (usually profound sadness or apathy, euphoria, or irritability). These disorders may be episodic or chronic.
  • Obsessive-Compulsive Disorder.
  • A condition that is characterized by the presence of obsessions and/or compulsions. Obsessions are recurrent, intrusive thoughts usually irrational worries that often necessitate behaviors to prevent untoward consequences (e.g., fears of contamination from dirt requiring the individual to wear gloves at all times). Compulsions are recurrent behaviors beyond the normal range that the individual feels compelled to undertake, usually to preserve personal safety, to avoid embarrassment, or to perform adequately (e.g., checking multiple times to see that the gas is turned off before leaving home). The disorder affects 1 to 2 percent of the population.
  • Open Trial.
  • A trial of a treatment in which both patient and practitioner are aware of the treatment being used.
  • Panic Disorder.
  • An anxiety disorder characterized by discrete intense periods of fear and associated symptoms. Panic disorder may be accompanied by agoraphobia.
  • Remission.
  • A return to the asymptomatic state, usually accompanied by a return to the usual level of psychosocial functioning.
  • Somatization Disorder.
  • A disorder characterized by multiple, often long-standing somatic complaints of bodily dysfunction (e.g., pain complaints, gastrointestinal disturbances). The disorder usually begins before the age of 30 and has a chronic, albeit fluctuating, course.
  • Supportive Therapy.
  • Psychotherapy that focuses on the management and resolution of current difficulties and life decisions using the patient's strengths and available resources.
  • Symptom Breakthrough.
  • The return of symptoms in the course of either continuation or maintenance phase treatment.
  • Vegetative Symptoms.
  • A group of symptoms that refer to sleep, appetite, and/or weight regulation.


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