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CMAG

Notes

6

  • Among males, adults ages 75 years and older have the highest rate of suicide (rate 37.97 per 100,000 population).11

  • Among females, those in their 40s and 50s have the highest rate of suicide (rate 7.53 per 100,000 population).11

  • Firearms are the most commonly used method of suicide among males (56.8%).11

  • Poisoning is the most common method of suicide for females

    • (37.8

      %).11

  • Suicide risk increases following discharge across diagnostic categories.13

DIAGNOSIS AND TREATMENT OF DEPRESSION

There are many mental illnesses. Mental illness is not diagnosed by a blood test, the way diabetes is. This complicates making an accurate diagnosis as well as monitoring the efficacy of the treatment.

Certain agents used in the treatment of depression have efficacy monitors, such as the antidepressant Pamelor (nortriptyline), which has what is known as a therapeutic window of efficacy (generally between 75-100 ng/ml). In addition, other medications such as lithium, Depakote and Tegretol also have important blood monitoring tests associated with them for a variety of reasons, including the determination of therapeutic levels. These few pharmacological agents offer blood monitoring tests, which may assist the treatment team in assessing efficacy or medication adherence. It is important to note, however, that there are just as many for which there are no blood monitoring tests to assess efficacy or medication adherence. And even with these monitoring tests, there remains no inclusive blood test for the diagnosis of mental illness.

Furthermore, the diagnostic lines between various mental illnesses can be blurred; to compartmentalize the following diagnoses may not offer the full picture of the individual the healthcare team has identified as requiring care management intervention. Each individual case is just that—individual. In depression, one size does not fit all, especially in pharmacotherapy, psychotherapy, and other treatment options.

There are three major subtypes of depression, all of which are categorized as mood disorders.14 They are listed below.

  • Major Depressive Disorder is the diagnosis given to individuals with a combination of the symptoms listed on page 13, which interfere with all aspects of their life.

  • Dysthymic Disorder, which is usually considered less severe yet more chronic than a major depressive episode.

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