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CMAG

Notes

12

Medications that may worsen depression include the following:

  • Beta-blockers

  • Calcium channel blockers

  • Interferons

  • Histamine-2 blockers

  • Clonidine and other anti-hypertensives

  • Corticosteroids

  • Procainimide

  • Indomethacin

  • Barbiturates

  • Narcotics

  • Phenytoin

  • Anabolic steroids

Strategies Used in Diagnosing Depression

Within every person is a spontaneous need for happiness, understanding, and love, yet neither psychiatry nor psychology has been effective in understanding the steps that lead to a happy life.

  • ROBERT CLONNINGER

Diagnosis of mental disorders is difficult due to the commonality of mental distress. In addition, there are no biological indicators of the presence of a

disorder.35

Mood disorders are “brain” disorders, meaning they are mediated

through the brain, yet they disrupt every facet of a person’s life: emotions, thought processes, behavior, and physical health.36 Therefore, the diagnosis of depression is quite a challenge.

Diagnosis of depression in the primary care setting can have a positive effect on social, physical, and mental functioning. As a member of the care management team, the primary care physician may be the first line of diagnosis. It is imperative that the results of screening and diagnosis be communicated with the full treatment team, including the care manager. Referral to specialized treatment with a psychiatrist or psychologist may be warranted. Discussion of pharmacotherapy may be conducted with a pharmacist on the team. The care manager is not in a role to diagnose or treat depression but may assist in identifying the patient who may be in the acute care setting, part of the care manager’s caseload due to a medical condition, or when regular communication occurs and symptoms are noticed. Depression can occur in any individual and must be on the radar of every care manager.

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