抑郁癥英文介紹

1、Depression-TheMentalIllnesswhatisdepressionDepressionisamentalhealthdisorder,apsychiatriccondition,characterizedbysadness,lossofinterestorpleasure,feelingsofguiltorlowself-worth.disturbedsleeporappetite.feelingsoftiredness,andpoorconcentration.Specifically,itisamooddisordercharacterizedbypersistentl

2、ylowmoodinwhichthereisafeelingofsadnessandlostofinterest.Depressionisdifferentfromthefluctuationsinmoodthatweallexperienceasapartofanormalandhealthylife.Temporaryemotionalresponsestothechallengesofeverydaylifedonotconstitutedepression.AccordingtotheUSCentersforDiseasePreventionandControl(CDC),8%ofpe

3、opleovertheageof12yearshasdepressioninanytwo-weekperiod.TheWorldHealthOrganization(WTO)putsdepressionatthetopofthelist-itisthemostcommon川nessworldwideandtheleadingceaseofdisability.Theorganizationestimatesthat350millionpeoplearoundtheworldareaffectedbydepression.MajorDepressivedisorderMajordepressiv

4、edisorder(MDD),alsoknownsimplyasdepression,isamentaldisordercharacterizedbyatleasttwoweeksoflowmoodthatispresentacrossmostsituations.Itisoftenaccompaniedbylowself-esteem,lossofinterestinnormallyenjoyableactivities,lowenergy,andpainwithoutaclearcause.Peoplemayalsooccasionallyhavefalsebeliefsorseeorhe

5、arthingsthatotherscannot.Somepeoplehaveperiodsofdepressionseparatedbyyearsinwhichtheyarenormalwhileothersnearlyalwayshavesymptomspresent.Majordepressivedisordercannegativelyaffectsaperson'sfamily,workorschoollife,sleepingoreatinghabits,andgeneralhealth.Between2-7%ofadultswithmajordepressiondieby

6、suicide,andupto60%ofpeoplewhodiebysuicidehaddepressionoranothermooddisorder.Thecauseisbelievedtobeacombinationofgenetic,environmental,andpsychologicalfactors.Riskfactorsincludeafamilyhistoryofthecondition,majorlifechanges,certainmedications,chronichealthproblems,andsubstanceabuse.About40%oftheriskap

7、pearstoberelatedtogenetics.Thediagnosisofmajordepressivedisorderisbasedontheperson'sreportedexperiencesandamentalstatusexamination.Thereisnolaboratorytestformajordepression.Testing,however,maybedonetoruleoutphysicalconditionsthatcancausesimilarsymptoms.Majordepressionshouldbedifferentiatedfromsa

8、dnesswhichisanormalpartoflifeandislesssevere.TheUnitedStatesPreventiveServicesTaskForce(USPSTF)recommendsscreeningfordepressionamongthoseovertheage12,whileapriorCochranereviewfoundinsufficientevidenceforscreening.Typically,peoplearetreatedwithcounsellingandantidepressantmedication.Medicationappearst

9、obeeffective,buttheeffectmayonlybesignificantinthemostseverelydepressed.Itisunclearwhethermedicationsaffecttheriskofsuicide.Typesofcounsellingusedincludecognitivebehavioraltherapy(CBT)andinterpersonaltherapy.Ifothermeasuresarenoteffectiveelectroconvulsivetherapy(ECT)maybetried.Hospitalizationmaybene

10、cessaryincaseswithariskofharmtoselfandmayoccasionallyoccuragainstaperson'swishes.Majordepressivedisorderaffectedapproximately253million(3.6%)ofpeoplein2013.Thepercentageofpeoplewhoareaffectedatonepointintheirlifevariesfrom7%inJapanto21%inFrance.Lifetimeratesarehigherinthedevelopedworld(15%)compa

11、redtothedevelopingworld(11%).Itcausesthesecondmostyearslivedwithdisabilityafterlowbackpain.Themostcommontimeofonsetisinapersonintheir20sand30s.Femalesareaffectedabouttwiceasoftenasmales.TheAmericanPsychiatricAssociationadded"majordepressivedisorder"totheDiagnosticandStatisticalManualofMent

12、alDisorders(DSM-III)in1980.ItwasasplitofthepreviousdepressiveneurosisintheDSM-IIwhichalsoencompassedtheconditionsnowknownasdysthymiaandadjustmentdisorderwithdepressedmood.Thosecurrentlyorpreviouslyaffectedmaybestigmatized.Whatarethesignsandsymptomsofdepression?depressionmaybetriggeredbystressfullife

13、events,otherillnesses,certaindrugsormedications,orinheritedtraits.althoughcausesofdepressionarenotentirelyunderstood,weknowitislinkedtoanimbalanceinbrainchemistry.oncetheimbalanceiscorrected,symptomsofdepressiongenerallyimprovePeoplewithdepressive川nessesdonotallexperiencethesamesymptoms.Theseverity,

14、frequencyanddurationofsymptomswillvarydependingontheindividualandhisorherparticularillness.Symptomsinclude:Persistentsad,anxiousor"empty"feelingsFeelingsofhopelessnessand/orpessimismFeelingsofguilt,worthlessnessand/orhelplessnessIrritability,restlessnessLossofinterestinactivitiesorhobbieso

15、ncepleasurable,includingsexFatigueanddecreasedenergyDifficultyconcentrating,rememberingdetailsandmakingdecisionsInsomnia,early-morningwakefulness,orexcessivesleepingOvereating,orappetitelossThoughtsofsuicide,suicideattemptsPersistentachesorpains,headaches,crampsordigestiveproblemsthatdonoteaseevenwi

16、thtreatmentAllofthesesymptomscaninterferewithyourqualityoflife.Evenifyoudon'thavemajordepression,ifyouhaveexperienceafewofthesesymptomsforatleasttwoweeksyoumayhavelesssevereformofdepressionthatstillrequirestreatment.thesymptomsofslightandmajordepressionDepressionisamedicalconditioninwhichaperson

17、feelsverysadandanxiousandoftenhasphysicalsymptoms.Slightdepressioncouldbeaportionofmajordepression,sothecriteriaforthisdiseaseareimportanttoconsiderandexamineforpeoplewiththeproblem.Ifthedepressionisonlyminor,itwillnothaveallofthecomponentsofmajordepressionandthereforewouldbetreateddifferentlyfromth

18、emoreseriousversionofthedisease.ThemostcommondiagnosticcriteriaareencapsulatedinthemnemonicdeviceSIGECAPS.Theyareintheorderoftheletters,Sleepproblems,lackofInterest,Guiltyfeelings,lackofEnergy,problemswithConcentration,Appetiteandweightdisturbances,Psychomotorretardation,andSuicidalthoughtsoractions

19、.Ifapersonhasfiveorsixitemsinthiscriteriaitisverylikelythattheyhavemajordepressionandtheyshouldbetreatedforit.Iftheyonlyhaveoneortwoofthemtheymighthavealessseriousversionofthedisease,butitstillmayrequiretreatment.Theonlydifferenceisthatitcouldbemoreminor.Byaskingaboutthesedifferentsymptoms,peopleper

20、formabasicdiagnosistesttoevaluatethemselvesortheirpatients.Thesymptomsofserioustoslightdepressionmaybeverydebilitatingtoapatientandidentificationoftheproblemisthefirststeptoafullrecovery.Theconditionofdepressivedisordersisprevalentthroughallwalksoflifeanditisexpectedthatthemajorityofpersonswillexper

21、iencesymptomsofdepressionatleastonceinthecourseoftheirlife.However,sincemostpeopleexperiencethesesymptomsatsomepoint,extendedresearchhasbeendonetodeterminethebestwaytotreatthesespecificconditionsandmanysolutionsareavailabletosufferers.Tothetissues,whichraisesthecarbondioxidelevel,causinggeneralDepre

22、ssion.AssociatedconditionsMajordepressionfrequentlyco-occurswithotherpsychiatricproblems.The1990-92NationalComorbiditySurvey(US)reportsthathalfofthosewithmajordepressionalsohavelifetimeanxietyanditsassociateddisorderssuchasgeneralizedanxietydisorder.Anxietysymptomscanhaveamajorimpactonthecourseofade

23、pressive川ness,withdelayedrecovery,increasedriskofrelapse,greaterdisabilityandincreasedsuicideattempts.AmericanneuroendocrinologistRobertSapolskysimilarlyarguesthattherelationshipbetweenstress,anxiety,anddepressioncouldbemeasuredanddemonstratedbiologically.Thereareincreasedratesofalcoholanddrugabusea

24、ndparticularlydependence,andaroundathirdofindividualsdiagnosedwithADHDdevelopcomorbiddepression.Post-traumaticstressdisorderanddepressionoftenco-occur.Depressionmayalsocoexistwithattentiondeficithyperactivitydisorder(ADHD),complicatingthediagnosisandtreatmentofboth.Depressionandpainoftenco-occur.One

25、ormorepainsymptomsarepresentin65%ofdepressedpatients,andanywherefrom5to85%ofpatientswithpainwillbesufferingfromdepression,dependingonthesetting;thereisalowerprevalenceingeneralpractice,andhigherinspecialtyclinics.Thediagnosisofdepressionisoftendelayedormissed,andtheoutcomeworsens.Theoutcomecanalsowo

26、rsenifthedepressionisnoticedbutcompletelymisunderstood.Depressionisalsoassociatedwitha1.5-to2-foldincreasedriskofcardiovasculardisease,independentofotherknownriskfactors,andisitselflinkeddirectlyorindirectlytoriskfactorssuchassmokingandobesity.Peoplewithmajordepressionarelesslikelytofollowmedicalrec

27、ommendationsfortreatingandpreventingcardiovasculardisorders,whichfurtherincreasestheirriskofmedicalcomplications.Inaddition,cardiologistsmaynotrecognizeunderlyingdepressionthatcomplicatesacardiovascularproblemundertheircare.ManagementThethreemostcommontreatmentsfordepressionarepsychotherapy,medicati

28、on,andelectroconvulsivetherapy.Psychotherapyisthetreatmentofchoice(overmedication)forpeopleunder18.TheUKNationalInstituteforHealthandCareExcellence(NICE)2004guidelinesindicatethatantidepressantsshouldnotbeusedfortheinitialtreatmentofmilddepression,becausetherisk-benefitratioispoor.Theguidelinesrecom

29、mendthatantidepressantstreatmentincombinationwithpsychosocialinterventionsshouldbeconsideredfor:PeoplewithahistoryofmoderateorseveredepressionThosewithmilddepressionthathasbeenpresentforalongperiodAsasecondlinetreatmentformilddepressionthatpersistsafterotherinterventionsAsafirstlinetreatmentformoder

30、ateorseveredepressionLifestylePhysicalexerciseisrecommendedformanagementofmilddepression,andhasamoderateeffectonsymptoms.Exercisehasalsobeenfoundtobeeffectivefor(unipolar)majordepression.Itisequivalenttotheuseofmedicationsorpsychologicaltherapiesinmostpeople.Intheolderpeopleitdoesappeartodecreasedep

31、ression.Exercisemayberecommendedtopeoplewhoarewilling,motivated,andphysicallyhealthyenoughtoparticipateinanexerciseprogramastreatment.Thereisasmallamountofevidencethatskippinganight'ssleepmayimprovedepressivesymptoms,withtheeffectsusuallyshowingupwithinaday.Thiseffectisusuallytemporary.Besidessl

32、eepiness,thismethodcancauseasideeffectofmaniaorhypomania.InobservationalstudiessmokingcessationhasbenefitsindepressionaslargeasorlargerthanthoseofmedicationsRangeMajordepressivedisorderaffectsapproximately253millionpeoplein2013(3.6%oftheglobalpopulation).Thepercentageofpeoplewhoareaffectedatonepointintheirlifevariesfrom7%inJapanto21%inFrance.Inmostcountriesthenumberofpeoplewhohavedepressionduringtheirlivesfallswithinan8-18%range.InNorthAmerica,theprobabilityofhavin