抑郁癥英文介紹.doc

Depression-The Mental Illness what is depression Depression is a mental health disorder , a psychiatric condition，characterized by sadness ,loss of interest or pleasure, feelings of guilt or low self-worth ,disturbed sleep or appetite ,feelings of tiredness , and poor concentration. Specifically,it is a mood disorder characterized by persistently low mood in which there is a feeling of sadness and lost of interest. Depression is different from the fluctuations in mood that we all experience as a part of a normal and healthy life. Temporary emotional responses to the challenges of everyday life do not constitute depression. According to the US Centers for Disease Prevention and Control (CDC),8% of people over the age of 12 years has depression in any two-week period. The World Health Organization (WTO)puts depression at the top of the list -it is the most common illness worldwide and the leading cease of disability.The organization estimates that 350 million people around the world are affected by depression. Major Depressive disorderMajor depressive disorder (MDD), also known simply as depression, is a mental disorder characterized by at least two weeks of low mood that is present across most situations. It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause.People may also occasionally have false beliefs or see or hear things that others cannot.Some people have periods of depression separated by years in which they are normal while others nearly always have symptoms present. Major depressive disorder can negatively affects a persons family, work or school life, sleeping or eating habits, and general health. Between 2-7% of adults with major depression die by suicide, and up to 60% of people who die by suicide had depression or another mood disorder.The cause is believed to be a combination of genetic, environmental, and psychological factors. Risk factors include a family history of the condition, major life changes, certain medications, chronic health problems, and substance abuse.About 40% of the risk appears to be related to genetics .The diagnosis of major depressive disorder is based on the persons reported experiences and a mental status examination. There is no laboratory test for major depression. Testing, however, may be done to rule out physical conditions that can cause similar symptoms.Major depression should be differentiated from sadness which is a normal part of life and is less severe.The United States Preventive Services Task Force (USPSTF) recommends screening for depression among those over the age 12, while a prior Cochrane review found insufficient evidence for screening.Typically, people are treated with counselling and antidepressant medication.Medication appears to be effective, but the effect may only be significant in the most severely depressed. It is unclear whether medications affect the risk of suicide. Types of counselling used include cognitive behavioral therapy (CBT) and interpersonal therapy. If other measures are not effective electroconvulsive therapy (ECT) may be tried. Hospitalization may be necessary in cases with a risk of harm to self and may occasionally occur against a persons wishes.Major depressive disorder affected approximately 253million (3.6%) of people in 2013. The percentage of people who are affected at one point in their life varies from 7% in Japan to 21% in France. Lifetime rates are higher in the developed world (15%) compared to the developing world (11%).It causes the second most years lived with disability after low back pain. The most common time of onset is in a person in their 20s and 30s. Females are affected about twice as often as males. The American Psychiatric Association added major depressive disorder to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. It was a split of the previous depressive neurosis in the DSM-II which also encompassed the conditions now known as dysthymia and adjustment disorder with depressed mood. Those currently or previously affected may be stigmatized.What are the signs and symptoms of depression?depression may be triggered by stressful life events, other illnesses, certain drugs or medications, or inherited traits. although causes of depression are not entirely understood, we know it is linked to an imbalance in brain chemistry. once the imbalance is corrected, symptoms of depression generally improvePeople with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness.Symptoms include:Persistent sad, anxious or empty feelingsFeelings of hopelessness and/or pessimismFeelings of guilt, worthlessness and/or helplessnessIrritability, restlessnessLoss of interest in activities or hobbies once pleasurable, including sexFatigue and decreased energyDifficulty concentrating, remembering details and making decisionsInsomnia, earlymorning wakefulness, or excessive sleepingOvereating, or appetite lossThoughts of suicide, suicide attemptsPersistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment All of these symptoms can interfere with your quality of life. Even if you dont have major depression , if you have experience a few of these symptoms for at least two weeks you may have less severe form of depression that still requires treatment. the symptoms of slight and major depressionDepression is a medical condition in which a person feels very sad and anxious and often has physical symptoms.Slight depression could be a portion of major depression, so the criteria for this disease are important to consider and examine for people with the problem. If the depression is only minor, it will not have all of the components of major depression and therefore would be treated differently from the more serious version of the disease.The most common diagnostic criteria are encapsulated in the mnemonic device SIGECAPS. They are in the order of the letters, Sleep problems, lack of Interest, Guilty feelings, lack of Energy, problems with Concentration, Appetite and weight disturbances, Psychomotor retardation, and Suicidal thoughts or actions. If a person has five or six items in this criteria it is very likely that they have major depression and they should be treated for it. If they only have one or two of them they might have a less serious version of the disease, but it still may require treatment. The only difference is that it could be more minor. By asking about these different symptoms, people perform a basic diagnosis test to evaluate themselves or their patients.The symptoms of serious to slight depression may be very debilitating to a patient and identification of the problem is the first step to a full recovery. The condition of depressive disorders is prevalent through all walks of life and it is expected that the majority of persons will experience symptoms of depression at least once in the course of their life. However, since most people experience these symptoms at some point, extended research has been done to determine the best way to treat these specific conditions and many solutions are available to sufferers. To the tissues, which raises the carbon dioxide level, causing general Depression. Associated conditionsMajor depression frequently co-occurs with other psychiatric problems. The 199092 National Comorbidity Survey (US) reports that half of those with major depression also have lifetime anxiety and its associated disorders such as generalized anxiety disorder. Anxiety symptoms can have a major impact on the course of a depressive illness, with delayed recovery, increased risk of relapse, greater disability and increased suicide attempts.American neuroendocrinologist Robert Sapolsky similarly argues that the relationship between stress, anxiety, and depression could be measured and demonstrated biologically.There are increased rates of alcohol and drug abuse and particularly dependence, and around a third of individuals diagnosed with ADHD develop comorbid depression. Post-traumatic stress disorder and depression often co-occur.Depression may also coexist with attention deficit hyperactivity disorder (ADHD), complicating the diagnosis and treatment of both.Depression and pain often co-occur. One or more pain symptoms are present in 65% of depressed patients, and anywhere from 5 to 85% of patients with pain will be suffering from depression, depending on the setting; there is a lower prevalence in general practice, and higher in specialty clinics. The diagnosis of depression is often delayed or missed, and the outcome worsens. The outcome can also worsen if the depression is noticed but completely misunderstood.Depression is also associated with a 1.5- to 2-fold increased risk of cardiovascular disease, independent of other known risk factors, and is itself linked directly or indirectly to risk factors such as smoking and obesity. People with major depression are less likely to follow medical recommendations for treating and preventing cardiovascular disorders, which further increases their risk of medical complications. In addition, cardiologists may not recognize underlying depression that complicates a cardiovascular problem under their care.ManagementThe three most common treatments for depression are psychotherapy, medication, and electroconvulsive therapy. Psychotherapy is the treatment of choice (over medication) for people under 18. The UK National Institute for Health and Care Excellence (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatment of mild depression, because the risk-benefit ratio is poor. The guidelines recommend that antidepressants treatment in combination with psychosocial interventions should be considered for:People with a history of moderate or severe depressionThose with mild depression that has been present for a long periodAs a second line treatment for mild depression that persists after other interventionsAs a first line treatment for moderate or severe depressionLifestylePhysical exercise is recommended for management of mild depression, and has a moderate effect on symptoms. Exercise has also been found to be effective for (unipolar) major depression. It is equivalent to the use of medications or psychological therapies in most people. In the older people it does appear to decrease depression.Exercise may be recommended to people who are willing, motivated, and physically healthy enough to participate in an exercise program as treatment.There is a small amount of evidence that skipping a nights sleep may improve depressive symptoms, with the effects usually showing up within a day. This effect is usually temporary. Besides sleepiness, this method can cause a side effect of mania or hypomania.In observational studies smoking cessation has benefits in depression as large as or larger than those of medicationsRangeMajor depressive disorder affects approximately 253million people in 2013 (3.6% of the global population).The percentage of people who are affected at one point in their life varies from 7% in Japan to 21% in France.In most countries the number of people who have depression during their lives falls within an 818% range. In North America, the probability of having a major dep