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Feature Article

A clinical approach to diagnosing depression in adults

Gordon Parker

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Abstract

Depression and its separate clinical expressions can be diagnosed in general practice settings by screening measures, observation and refined symptom assessment, as well as by interview of corroborative witnesses, especially relatives.

Key Points

  • Depression, anxiety and grief are often regarded as synonymous, but need to be differentiated.
  • A set of probe questions enquiring about depression, lowered self-esteem and increased self-criticism will generally identify most depressed people.
  • Normal depression is common and lasts only minutes, hours or days.
  • Clinical depression is depression with a mood state of some severity that has lasted more than two weeks and has an impairment component in functioning.
  • Patients with the melancholic subtype of clinical depression have psychomotor disturbance; patients with the psychotic subtype additionally have psychotic features; and patients with the nonmelancholic subtype have neither psychomotor nor psychotic features.

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