Differential diagnoses of depression

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Neuroimaging can be a valuable tool in the diagnostic work-up of various psychiatric disorders including depression. Mrt big.jpg
Neuroimaging can be a valuable tool in the diagnostic work-up of various psychiatric disorders including depression.

Depression, one of the most commonly diagnosed psychiatric disorders, [2] [3] is being diagnosed in increasing numbers in various segments of the population worldwide. [4] [5] Depression in the United States alone affects 17.6 million Americans each year or 1 in 6 people. Depressed patients are at increased risk of type 2 diabetes, cardiovascular disease and suicide. Within the next twenty years depression is expected to become the second leading cause of disability worldwide and the leading cause in high-income nations, including the United States. In approximately 75% of suicides, the individuals had seen a physician within the prior year before their death, 45–66% within the prior month. About a third of those who died by suicide had contact with mental health services in the prior year, a fifth within the preceding month. [6] [7] [8] [9] [10]

Contents

There are many psychiatric and medical conditions that may mimic some or all of the symptoms of depression or may occur comorbid to it. [11] [12] [13] A disorder either psychiatric or medical that shares symptoms and characteristics of another disorder, and may be the true cause of the presenting symptoms is known as a differential diagnosis. [14]

Many psychiatric disorders such as depression are diagnosed by allied health professionals with little or no medical training, [15] and are made on the basis of presenting symptoms without proper consideration of the underlying cause, adequate screening of differential diagnoses is often not conducted. [16] [17] [18] [19] [20] [21] According to one study, "non-medical mental health care providers may be at increased risk of not recognizing masked medical illnesses in their patients." [22]

Misdiagnosis or missed diagnoses may lead to lack of treatment or ineffective and potentially harmful treatment which may worsen the underlying causative disorder. [23] [24] A conservative estimate is that 10% of all psychological symptoms may be due to medical reasons, [25] with the results of one study suggesting that about half of individuals with a serious mental illness "have general medical conditions that are largely undiagnosed and untreated and may cause or exacerbate psychiatric symptoms". [26] [27]

In a case of misdiagnosed depression recounted in Newsweek , a writer received treatment for depression for years; during the last 10 years of her depression the symptoms worsened, resulting in multiple suicide attempts and psychiatric hospitalizations. When an MRI finally was performed, it showed the presence of a tumor. However, she was told by a neurologist that it was benign. After a worsening of symptoms, and upon the second opinion of another neurologist, the tumor was removed. After the surgery, she no longer had depressive symptoms. [28]

Autoimmune disorders

"However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology." [29]

Bacterial-viral-parasitic infection

MRI brain scan: Neurocysticercosis Neurocysticercosis.gif
MRI brain scan: Neurocysticercosis
"Because of the rapid rise of Lyme borreliosis nationwide and the need for antibiotic treatment to prevent severe neurologic damage, mental health professionals need to be aware of its possible psychiatric presentations. [35]

Blood disorders

Chronic fatigue syndrome

Between 1 and 4 million Americans are believed to have chronic fatigue syndrome (CFS), yet only 50% have consulted a physician for symptoms of CFS. In addition individuals with CFS symptoms often have an undiagnosed medical or psychiatric disorder such as diabetes, thyroid disease or substance abuse. CFS, at one time considered to be psychosomatic in nature, is now considered to be a valid medical condition in which early diagnosis and treatment can aid in alleviating or completely resolving symptoms. [50] While frequently misdiagnosed as depression, [51] differences have been noted in rate of cerebral blood flow. [52]

CFS is underdiagnosed in more than 80% of the people who have it; at the same time, it is often misdiagnosed as depression. [53]

Dietary disorders

"Fructose malabsorption may play a role in the development of depressed mood. Fructose malabsorption should be considered in patients with symptoms of major depression...." [55]
"Fructose and sorbitol reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression." [56]

Endocrine system disorders

Dysregulation of the endocrine system may present with various neuropsychiatric symptoms; irregularities in the hypothalamic-pituitary- adrenal (HPA) axis and the hypothalamic-pituitary-thyroid (HPT) axis have been shown in patients with primary depression. [57]

HPT and HPA axes abnormalities observed in patients with depression
(Musselman DL, Nemeroff CB. 1996)

HPT axes irregularities:

HPA axes irregularities:

Adrenal gland

Thyroid and parathyroid glands

Illu thyroid parathyroid.jpg

Pituitary tumors

Tumors of the pituitary gland are fairly common in the general population with estimates ranging as high as 25%. [62] Most tumors are considered to be benign and are often an incidental finding discovered during autopsy or as of neuroimaging in which case they are dubbed "incidentalomas". Even in benign cases, pituitary tumors can affect cognitive, behavioral and emotional changes. [63] [64] Pituitary microadenomas are smaller than 10 mm in diameter and are generally considered benign, yet the presence of a microadenoma has been positively identified as a risk factor for suicide. [65] [66]

"... patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression". [67]

Pancreas

Neurological

CNS Tumors

In addition to pituitary tumors, tumors in various locations in the central nervous system may cause depressive symptoms and be misdiagnosed as depression. [28] [69]

Post concussion syndrome

Post-concussion syndrome (PCS), is a set of symptoms that a person may experience for weeks, months, or occasionally years after a concussion with a prevalence rate of 38–80% in mild traumatic brain injuries, it may also occur in moderate and severe cases of traumatic brain injury. [70] A diagnosis may be made when symptoms resulting from concussion, depending on criteria, last for more than three to six months after the injury, in which case it is termed persistent postconcussive syndrome (PPCS). [71] [72] [73] [74] [75] In a study of the prevalence of post concussion syndrome symptoms in patients with depression utilizing the British Columbia Postconcussion Symptom Inventory: "Approximately 9 out of 10 patients with depression met liberal self-report criteria for a postconcussion syndrome and more than 5 out of 10 met conservative criteria for the diagnosis." These self reported rates were significantly higher than those obtained in a scheduled clinical interview. Normal controls have exhibited symptoms of PCS as well as those seeking psychological services. There is considerable debate over the diagnosis of PCS in part because of the medico-legal and thus monetary ramifications of receiving the diagnosis. [76]

Pseudobulbar affect

Diagnostic differences between PBA and depression PBA is not depression.png
Diagnostic differences between PBA and depression

Pseudobulbar affect (PBA) is an affective disinhibition syndrome that is largely unrecognized in clinical settings and thus often untreated due to ignorance of the clinical manifestations of the disorder; it may be misdiagnosed as depression. [77] It often occurs secondary to various neurodegenerative diseases such as amyotrophic lateral sclerosis, and also can result from head trauma. PBA is characterized by involuntary and inappropriate outbursts of laughter and/or crying. PBA has a high prevalence rate with estimates of 1.5–2 million cases in the United States alone. [78]

Multiple sclerosis

Multiple sclerosis is a chronic demyelinating disease in which the myelin sheaths of cells in the brain and spinal cord are irreparably damaged. Symptoms of depression are very common in patients at all stages of the disease and may be exacerbated by medical treatments, notably interferon beta-1a. [79]

Neurotoxicity

Various compounds have been shown to have neurotoxic effects many of which have been implicated as having a causal relationship in the development of depression.

Cigarette smoking

There has been research which suggests a correlation between cigarette smoking and depression. The results of one recent study suggest that smoking cigarettes may have a direct causal effect on the development of depression. [80] There have been various studies done showing a positive link between smoking, suicidal ideation and suicide attempts. [81] [82]

In a study conducted among nurses, those smoking between 1-24 cigarettes per day had twice the suicide risk; 25 cigarettes or more, 4 times the suicide risk, than those who had never smoked. [83] [84] In a study of 300,000 male U.S. Army soldiers, a definitive link between suicide and smoking was observed with those smoking over a pack a day having twice the suicide rate of non-smokers. [85]

Link Between Smoking Depression and Suicide

"Current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt." [86]

"It would seem unwise, nevertheless, to rule out the possibility that smoking might be among the antecedent factors associated with the development of depression." [87]

"Abstinence from cigarettes for prolonged periods may be associated with a decrease in depressive symptomatology." [88]

"The stress induction model of smoking suggests, however, that smoking causes stress and concomitant negative affect." [89]

Medication

Various medications have been suspected of having a causal relation in the development of depression; this has been classified as "organic mood syndrome". Some classes of medication such as those used to treat hypertension, have been recognized for decades as having a definitive relationship with the development of depression. [90]

Monitoring of those taking medications which have shown a relationship with depression is often indicated, as well as the necessity of factoring in the use of such medications in the diagnostic process. [91]

Chronic exposure to organophosphates

The neuropsychiatric effects of chronic organophosphate exposure include mood disorders, suicidal thinking and behaviour, cognitive impairment and chronic fatigue. [94]

Neuropsychiatric

Bipolar disorder

Nutritional deficiencies

Nutrition plays a key role in every facet of maintaining proper physical and psychological wellbeing. Insufficient or inadequate nutrition can have a profound effect on mental health. The emerging field of nutritional neuroscience explores the various connections between diet, neurological functioning and mental health.

Sleep disorders

See also

Related Research Articles

<span class="mw-page-title-main">Bipolar disorder</span> Mental disorder that causes periods of depression and abnormally elevated mood

Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that each last from days to weeks. If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually also a reduced need for sleep during manic phases. During periods of depression, the individual may experience crying and have a negative outlook on life and poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.

<span class="mw-page-title-main">Catatonia</span> Psychiatric behavioral syndrome

Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episodes. It has historically been related to schizophrenia, but catatonia is most often seen in mood disorders. It is now known that catatonic symptoms are nonspecific and may be observed in other mental, neurological, and medical conditions. Catatonia is now a stand-alone diagnosis, and the term is used to describe a feature of the underlying disorder.

<span class="mw-page-title-main">Major depressive disorder</span> Mental disorder involving persistent low mood, low self-esteem, and loss of interest

Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since.

<span class="mw-page-title-main">Mood disorder</span> Mental disorder affecting the mood of an individual, over a long period of time.

A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).

<span class="mw-page-title-main">Akathisia</span> Movement disorder involving a feeling of inner restlessness

Akathisia is a movement disorder characterized by a subjective feeling of inner restlessness accompanied by mental distress and an inability to sit still. Usually, the legs are most prominently affected. Those affected may fidget, rock back and forth, or pace, while some may just have an uneasy feeling in their body. The most severe cases may result in aggression, violence, and/or suicidal thoughts. Akathisia is also associated with threatening behaviour and physical aggression that is greatest in patients with mild akathisia, and diminishing with increasing severity of akathisia.

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.

<span class="mw-page-title-main">Mood swing</span> Extreme or rapid change in mood

A mood swing is an extreme or sudden change of mood. Such changes can play a positive part in promoting problem solving and in producing flexible forward planning, or be disruptive. When mood swings are severe, they may be categorized as part of a mental illness, such as bipolar disorder, where erratic and disruptive mood swings are a defining feature.

Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by emotional, cognitive, and physical symptoms. PMDD causes significant distress or impairment in menstruating women during the luteal phase of the menstrual cycle. The symptoms occur in the luteal phase, improve within a few days after the onset of menses, and are minimal or absent in the week after menses. PMDD has a profound impact on a person's quality of life and dramatically increases the risk of suicidal ideation and even suicide attempts. Many women of reproductive age experience discomfort or mild mood changes prior to menstruation. However, 5–8% experience severe premenstrual syndrome causing significant distress or functional impairment. Within this population of reproductive age, some will meet the criteria for PMDD.

<span class="mw-page-title-main">Depression (mood)</span> State of low mood and aversion to activity

Depression is a mental state of low mood and aversion to activity. It affects more than 280 million people of all ages. Depression affects a person's thoughts, behavior, feelings, and sense of well-being. Depressed people often experience loss of motivation or interest in, or reduced pleasure or joy from, experiences that would normally bring them pleasure or joy. Depressed mood is a symptom of some mood disorders such as major depressive disorder and dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. It may feature sadness, difficulty in thinking and concentration and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection or hopelessness and may experience suicidal thoughts. It can either be short term or long term.

Adjustment disorder is a maladaptive response to a psychosocial stressor. It is classified as a mental disorder. The maladaptive response usually involves otherwise normal emotional and behavioral reactions that manifest more intensely than usual, causing marked distress, preoccupation with the stressor and its consequences, and functional impairment.

Dysthymia, also known as persistent depressive disorder (PDD), is a mental and behavioral disorder, specifically a disorder primarily of mood, consisting of similar cognitive and physical problems as major depressive disorder, but with longer-lasting symptoms. The concept was used by Robert Spitzer as a replacement for the term "depressive personality" in the late 1970s.

Atypical depression is defined in the DSM IV as depression that shares many of the typical symptoms of major depressive disorder or dysthymia but is characterized by improved mood in response to positive events. In contrast to those with atypical depression, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events. Atypical depression also often features significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs, and interpersonal rejection sensitivity that results in significant social or occupational impairment.

<span class="mw-page-title-main">Psychotic depression</span> Medical condition

Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms. It can occur in the context of bipolar disorder or major depressive disorder. It can be difficult to distinguish from schizoaffective disorder, a diagnosis that requires the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Unipolar psychotic depression requires that psychotic symptoms occur during severe depressive episodes, although residual psychotic symptoms may also be present in between episodes. Diagnosis using the DSM-5 involves meeting the criteria for a major depressive episode, along with the criteria for "mood-congruent or mood-incongruent psychotic features" specifier.

Treatment-resistant depression is a term used in psychiatry to describe people with major depressive disorder (MDD) who do not respond adequately to a course of appropriate antidepressant medication within a certain time. Definitions of treatment-resistant depression vary, and they do not include a resistance to psychological therapies. Inadequate response has most commonly been defined as less than 50% reduction in depressive symptoms following treatment with at least one antidepressant medication, although definitions vary widely. Some other factors that may contribute to inadequate treatment are: a history of repeated or severe adverse childhood experiences, early discontinuation of treatment, insufficient dosage of medication, patient noncompliance, misdiagnosis, cognitive impairment, low income and other socio-economic variables, and concurrent medical conditions, including comorbid psychiatric disorders. Cases of treatment-resistant depression may also be referred to by which medications people with treatment-resistant depression are resistant to. In treatment-resistant depression adding further treatments such as psychotherapy, lithium, or aripiprazole is weakly supported as of 2019.

Bipolar II disorder (BP-II) is a mood disorder on the bipolar spectrum, characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for BP-II requires that the individual must never have experienced a full manic episode. Otherwise, one manic episode meets the criteria for bipolar I disorder (BP-I).

Pseudodementia is a condition where mental cognition can be temporarily decreased. The term pseudodementia is applied to the range of functional psychiatric conditions such as depression, schizophrenia and hysteria that may mimic organic dementia, but are essentially reversible on treatment. Pseudodementia typically involves three cognitive components: memory issues, deficits in executive functioning, and deficits in speech and language. Specific cognitive symptoms might include trouble recalling words or remembering things in general, decreased attentional control and concentration, difficulty completing tasks or making decisions, decreased speed and fluency of speech, and impaired processing speed. People with pseudodementia are typically very distressed about the cognitive impairment they experience. With in this condition, there are two specific treatments that have been found to be effective for the treatment of depression, and these treatments may also be beneficial in the treatment of pseudodementia. Cognitive behavioral therapy (CBT) involves exploring and changing thought patterns and behaviors in order to improve one's mood. Interpersonal therapy focuses on the exploration of an individual's relationships and identifying any ways in which they may be contributing to feelings of depression.

Late-life depression refers to depression occurring in older adults and has diverse presentations, including as a recurrence of early-onset depression, a new diagnosis of late-onset depression, and a mood disorder resulting from a separate medical condition, substance use, or medication regimen. Research regarding late-life depression often focuses on late-onset depression, which is defined as a major depressive episode occurring for the first time in an older person.

<span class="mw-page-title-main">Selective serotonin reuptake inhibitor</span> Class of antidepressant medication

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.

The differential diagnoses of anorexia nervosa (AN) includes various types of medical and psychological conditions, which may be misdiagnosed as AN. In some cases, these conditions may be comorbid with AN because the misdiagnosis of AN is not uncommon. For example, a case of achalasia was misdiagnosed as AN and the patient spent two months confined to a psychiatric hospital. A reason for the differential diagnoses that surround AN arise mainly because, like other disorders, it is primarily, albeit defensively and adaptive for, the individual concerned. Anorexia Nervosa is a psychological disorder characterized by extremely reduced intake of food. People with anorexia nervosa have a low self-image and consider themselves overweight.

Borderline personality disorder (BPD) is a psychological disorder characterized by chronic instability of relationships, self-image, moods, and affect, which is frequently misdiagnosed. This misdiagnosis can come in the form of providing a BPD diagnosis to a person who does not actually meet criteria or providing an incorrect alternative diagnosis in the place of a BPD diagnosis.

References

  1. ↑ Neuroimaging: a new training issue in psychiatry? -- Bhriain et al. 2005 - Archived 2010-04-27 at the Wayback Machine
  2. ↑ Sharp LK, Lipsky MS (September 2002). "Screening for depression across the lifespan: a review of measures for use in primary care settings". American Family Physician. 66 (6): 1001–8. PMID   12358212.
  3. ↑ Torzsa P, Szeifert L, Dunai K, Kalabay L, Novák M (September 2009). "A depresszió diagnosztikája és kezelése a családorvosi gyakorlatban". Orvosi Hetilap. 150 (36): 1684–93. doi: 10.1556/OH.2009.28675 . PMID   19709983.
  4. ↑ College Students Exhibiting More Severe Mental Illness, Study Finds
  5. ↑ Lambert KG (2006). "Rising rates of depression in today's society: Consideration of the roles of effort-based rewards and enhanced resilience in day-to-day functioning". Neuroscience & Biobehavioral Reviews. 30 (4): 497–510. doi:10.1016/j.neubiorev.2005.09.002. PMID   16253328. S2CID   12525915.
  6. ↑ Depression and Suicide Andrew B. Medscape
  7. ↑ González HM; Vega WA; Williams DR; Tarraf W; West BT; Neighbors HW (January 2010). "Depression Care in the United States: Too Little for Too Few". Archives of General Psychiatry. 67 (1): 37–46. doi:10.1001/archgenpsychiatry.2009.168. PMC   2887749 . PMID   20048221.
  8. ↑ Luoma JB, Martin CE, Pearson JL (June 2002). "Contact with mental health and primary care providers before suicide: a review of the evidence". The American Journal of Psychiatry. 159 (6): 909–16. doi:10.1176/appi.ajp.159.6.909. PMC   5072576 . PMID   12042175.
  9. ↑ Lee HC, Lin HC, Liu TC, Lin SY (June 2008). "Contact of mental and nonmental health care providers prior to suicide in Taiwan: a population-based study". Canadian Journal of Psychiatry. 53 (6): 377–83. doi: 10.1177/070674370805300607 . PMID   18616858.
  10. ↑ Pirkis J, Burgess P (December 1998). "Suicide and recency of health care contacts. A systematic review". The British Journal of Psychiatry. 173 (6): 462–74. doi:10.1192/bjp.173.6.462. PMID   9926074. S2CID   43144463.
  11. ↑ Adults Admitted to a Mood-Disorder Clinic Are Often Misdiagnosed by Marlene Busko
  12. ↑ Jones DR, Macias C, Barreira PJ, Fisher WH, Hargreaves WA, Harding CM (November 2004). "Prevalence, Severity, and Co-occurrence of Chronic Physical Health Problems of Persons with Serious Mental Illness". Psychiatric Services. 55 (11): 1250–7. doi:10.1176/appi.ps.55.11.1250. PMC   2759895 . PMID   15534013.
  13. ↑ Felker B, Yazel JJ, Short D (December 1996). "Mortality and medical comorbidity among psychiatric patients: a review". Psychiatric Services. 47 (12): 1356–63. doi:10.1176/ps.47.12.1356. PMID   9117475.
  14. ↑ Merriam-Webster's Medical Dictionary, Merriam-Webster, Inc.
  15. ↑ Preventing Misdiagnosis of Women: A Guide to Physical Disorders That Have Psychiatric Symptoms (Women's Mental Health and Development) by Dr. Elizabeth Adele Klonoff and Dr. Hope Landrine p. xxi Publisher: Sage Publications, Inc; 1 edition (1997) Language: English ISBN   0761900470
  16. ↑ Singh H, Thomas EJ, Wilson L, et al. (July 2010). "Errors of Diagnosis in Pediatric Practice: A Multisite Survey". Pediatrics. 126 (1): 70–9. doi:10.1542/peds.2009-3218. PMC   2921702 . PMID   20566604.
  17. ↑ Margolis RL (1994). "Nonpsychiatrist house staff frequently misdiagnose psychiatric disorders in general hospital inpatients". Psychosomatics. 35 (5): 485–91. doi: 10.1016/S0033-3182(94)71743-6 . PMID   7972664.
  18. ↑ Clinical errors and medical negligence Femi Oyebode; Advances in Psychiatric Treatment (2006) 12: 221-227 The Royal College of Psychiatrists
  19. ↑ Scheinbaum BW (1979). "Psychiatric diagnostic error". Schizophrenia Bulletin. 5 (4): 560–3. doi: 10.1093/schbul/5.4.560 . PMID   515705.
  20. ↑ Hall RC, Popkin MK, Devaul RA, Faillace LA, Stickney SK (November 1978). "Physical illness presenting as psychiatric disease". Archives of General Psychiatry. 35 (11): 1315–20. doi:10.1001/archpsyc.1978.01770350041003. PMID   568461.
  21. ↑ Small GW (December 2009). "Differential Diagnoses and Assessment of Depression in Elderly Patients". The Journal of Clinical Psychiatry. 70 (12): e47. doi:10.4088/JCP.8001tx20c. PMID   20141704.
  22. ↑ Grace GD, Christensen RC (2007). "Recognizing psychologically masked illnesses: the need for collaborative relationships in mental health care". Primary Care Companion to the Journal of Clinical Psychiatry. 9 (6): 433–6. doi:10.4088/pcc.v09n0605. PMC   2139921 . PMID   18185822.
  23. ↑ Witztum E, Margolin J, Bar-On R, Levy A (1995). "Stigma, labelling and psychiatric misdiagnosis: origins and outcomes". Medicine and Law. 14 (7–8): 659–69. PMID   8668014.
  24. ↑ Margolin J, Witztum E, Levy A (June 1995). "Consequences of misdiagnosis and labeling in psychiatry". Harefuah. 128 (12): 763–7, 823. PMID   7557684.
  25. ↑ When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists. Morrison J: New York, Guilford, 1997 ISBN   1-57230-539-8
  26. ↑ Previously undetected metabolic syndromes and infectious diseases among psychiatric inpatients. Psychiatric Services Rothbard AB,et al: 60:534–537,2009
  27. ↑ Hall RC, Gardner ER, Stickney SK, LeCann AF, Popkin MK (September 1980). "Physical illness manifesting as psychiatric disease. II. Analysis of a state hospital inpatient population". Archives of General Psychiatry. 37 (9): 989–95. doi:10.1001/archpsyc.1980.01780220027002. PMID   7416911.
  28. 1 2 Is It Depression--or a Tumor? - Newsweek Nov 21, 2007
  29. ↑ Bushara KO (April 2005). "Neurologic presentation of celiac disease". Gastroenterology. 128 (4 Suppl 1): S92–7. doi: 10.1053/j.gastro.2005.02.018 . PMID   15825133.
  30. ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN   0-7216-2921-0.
  31. ↑ Lupus Disease Activity May Cause, Worsen Depression — Psychiatric Newsby J Arehart-Trechel - 2006 Archived March 25, 2006, at the Wayback Machine
  32. ↑ Fallon BA, Nields JA (November 1994). "Lyme disease: a neuropsychiatric illness". The American Journal of Psychiatry. 151 (11): 1571–83. doi:10.1176/ajp.151.11.1571. PMID   7943444. S2CID   22568915.
  33. ↑ Hájek T, Pasková B, Janovská D, et al. (February 2002). "Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjects". The American Journal of Psychiatry. 159 (2): 297–301. doi:10.1176/appi.ajp.159.2.297. PMID   11823274.
  34. ↑ Fallon BA, Kochevar JM, Gaito A, Nields JA (September 1998). "The underdiagnosis of neuropsychiatric Lyme disease in children and adults". The Psychiatric Clinics of North America. 21 (3): 693–703, viii. doi: 10.1016/s0193-953x(05)70032-0 . PMID   9774805.
  35. ↑ Fallon BA, Nields JA, Parsons B, Liebowitz MR, Klein DF (July 1993). "Psychiatric manifestations of Lyme borreliosis". The Journal of Clinical Psychiatry. 54 (7): 263–8. PMID   8335653.
  36. ↑ Friedrich F, Geusau A, Greisenegger S, Ossege M, Aigner M (2009). "Manifest psychosis in neurosyphilis". General Hospital Psychiatry. 31 (4): 379–81. doi:10.1016/j.genhosppsych.2008.09.010. PMID   19555800.
  37. ↑ García HH, Evans CA, Nash TE, et al. (October 2002). "Current consensus guidelines for treatment of neurocysticercosis". Clin. Microbiol. Rev. 15 (4): 747–56. doi:10.1128/CMR.15.4.747-756.2002. PMC   126865 . PMID   12364377.
  38. ↑ Sorvillo FJ, DeGiorgio C, Waterman SH (February 2007). "Deaths from cysticercosis, United States". Emerging Infectious Diseases. 13 (2): 230–5. doi:10.3201/eid1302.060527. PMC   2725874 . PMID   17479884.
  39. ↑ Almeida SM, Gurjão SA (February 2010). "Frequency of depression among patients with neurocysticercosis". Arquivos de Neuro-Psiquiatria. 68 (1): 76–80. doi: 10.1590/s0004-282x2010000100017 . PMID   20339658.
  40. ↑ Carruthers VB, Suzuki Y (May 2007). "Effects of Toxoplasma gondii Infection on the Brain". Schizophrenia Bulletin. 33 (3): 745–51. doi:10.1093/schbul/sbm008. PMC   2526127 . PMID   17322557.
  41. ↑ Henriquez SA, Brett R, Alexander J, Pratt J, Roberts CW (2009). "Neuropsychiatric Disease and Toxoplasma gondii Infection". Neuroimmunomodulation. 16 (2): 122–33. doi:10.1159/000180267. PMID   19212132. S2CID   7382051.
  42. ↑ Nilamadhab Karl; Baikunthanath Misra (February 2004). "Toxoplasma gondii serpositivity and depression: a case report". BMC Psychiatry. 4 (1): 1. doi: 10.1186/1471-244X-4-1 . PMC   356918 . PMID   15018628.
  43. ↑ Yagmur, F; Yazar, S; Temel, HO; Cavusoglu, M (2010). "May Toxoplasma gondii increase suicide attempt-preliminary results in Turkish subjects?". Forensic Science International. 199 (1–3): 15–7. doi:10.1016/j.forsciint.2010.02.020. PMID   20219300.
  44. ↑ Depression after infection with West Nile virus Murray KO, Resnick M, Miller V. Depression after infection with West Nile virus. Emerg Infect Dis [serial on the Internet]. 2007 Mar [Retrieved July 9, 2010]. Available from
  45. ↑ Berg PJ, Smallfield S, Svien L (April 2010). "An investigation of depression and fatigue post West Nile virus infection". South Dakota Medicine. 63 (4): 127–9, 131–3. PMID   20397375.
  46. ↑ Zeller HG, Schuffenecker I (March 2004). "West Nile Virus: An Overview of Its Spread in Europe and the Mediterranean Basin in Contrast to Its Spread in the Americas". European Journal of Clinical Microbiology & Infectious Diseases. 23 (3): 147–56. doi:10.1007/s10096-003-1085-1. PMID   14986160. S2CID   24372103.
  47. ↑ Carson PJ, Konewko P, Wold KS, et al. (September 2006). "Long‐Term Clinical and Neuropsychological Outcomes of West Nile Virus Infection". Clinical Infectious Diseases. 43 (6): 723–30. doi: 10.1086/506939 . PMID   16912946. S2CID   2765866.
  48. ↑ MedicineNet.com Definition of Anemia
  49. ↑ Onder G, Penninx BW, Cesari M, et al. (September 2005). "Anemia is associated with depression in older adults: results from the InCHIANTI study" (PDF). The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 60 (9): 1168–72. doi: 10.1093/gerona/60.9.1168 . PMID   16183958.
  50. ↑ CDC - Chronic Fatigue Syndrome Jul 1, 2010 ... CDC Centers for Disease Control and Prevention Chronic Fatigue Syndrome.
  51. ↑ Griffith JP, Zarrouf FA (2008). "A Systematic Review of Chronic Fatigue Syndrome: Don't Assume It's Depression". Primary Care Companion to the Journal of Clinical Psychiatry. 10 (2): 120–8. doi:10.4088/pcc.v10n0206. PMC   2292451 . PMID   18458765.
  52. ↑ MacHale SM, Lawŕie SM, Cavanagh JT, et al. (June 2000). "Cerebral perfusion in chronic fatigue syndrome and depression". The British Journal of Psychiatry. 176 (6): 550–6. doi: 10.1192/bjp.176.6.550 . PMID   10974961.
  53. ↑ Griffith JP, Zarrouf FA.,2008
  54. ↑ Ledochowski M, Widner B, Sperner-Unterweger B, Propst T, Vogel W, Fuchs D (July 2000). "Carbohydrate malabsorption syndromes and early signs of mental depression in females". Digestive Diseases and Sciences. 45 (7): 1255–9. doi:10.1023/A:1005527230346. PMID   10961700. S2CID   25720361.
  55. ↑ Ledochowski M, Sperner-Unterweger B, Widner B, Fuchs D (June 1998). "Fructose malabsorption is associated with early signs of mental depression". European Journal of Medical Research. 3 (6): 295–8. PMID   9620891.
  56. ↑ Ledochowski M, Widner B, Bair H, Probst T, Fuchs D (October 2000). "Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers". Scandinavian Journal of Gastroenterology. 35 (10): 1048–52. CiteSeerX   10.1.1.491.1764 . doi:10.1080/003655200451162. PMID   11099057. S2CID   218909742.
  57. ↑ Musselman DL, Nemeroff CB (June 1996). "Depression and endocrine disorders: focus on the thyroid and adrenal system". The British Journal of Psychiatry. Supplement. 168 (30): 123–8. doi:10.1192/S0007125000298504. PMID   8864158. S2CID   38909762.
  58. ↑ Iwata M, Hazama GI, Shirayama Y, Ueta T, Yoshioka S, Kawahara R (2004). "A case of Addison's disease presented with depression as a first symptom". Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica. 106 (9): 1110–6. PMID   15580869.
  59. ↑ Sonino, N (2001). "Psychiatric disorders associated with Cushing's syndrome. Epidemiology, pathophysiology and treatment". CNS Drugs. 15 (1172–7047): 361–73. doi:10.2165/00023210-200115050-00003. PMID   11475942. S2CID   34438879.
  60. ↑ McLachlan SM, Nagayama Y, Pichurin PN, et al. (December 2007). "The Link between Graves' Disease and Hashimoto's Thyroiditis: A Role for Regulatory T Cells". Endocrinology. 148 (12): 5724–33. doi: 10.1210/en.2007-1024 . PMID   17823263.
  61. ↑ Bohrer T, Krannich JH (2007). "Depression as a manifestation of latent chronic hypoparathyroidism". World Journal of Biological Psychiatry. 8 (1): 56–9. doi:10.1080/15622970600995146. PMID   17366354. S2CID   23319026.
  62. ↑ Pituitary Macroadenomas eMedicine
  63. ↑ Meyers CA (1998). "Neurobehavioral functioning of adults with pituitary disease". Psychotherapy and Psychosomatics. 67 (3): 168–72. doi:10.1159/000012277. PMID   9667064. S2CID   46806241.
  64. ↑ Ezzat S, Asa SL, Couldwell WT, et al. (August 2004). "The prevalence of pituitary adenomas". Cancer. 101 (3): 613–9. doi: 10.1002/cncr.20412 . PMID   15274075. S2CID   16595581.
  65. ↑ Alicja Furgal-Borzycha; et al. (October 2007). "Increased Incidence of Pituitary Microadenomas in Suicide Victims". Neuropsychobiology. 55 (3–4): 163–166. doi:10.1159/000106475. PMID   17657169. S2CID   34408650.
  66. ↑ Forensic Neuropathology p. 137 By Jan E. Leestma
  67. ↑ Weitzner MA, Kanfer S, Booth-Jones M (2005). "Apathy and Pituitary Disease: It Has Nothing to Do With Depression". Journal of Neuropsychiatry. 17 (2): 159–66. doi:10.1176/appi.neuropsych.17.2.159. PMID   15939968.
  68. ↑ Dowdy DW, Dinglas V, Mendez-Tellez PA, et al. (October 2008). "Intensive care unit hypoglycemia predicts depression during early recovery from acute lung injury*". Critical Care Medicine. 36 (10): 2726–33. doi:10.1097/CCM.0b013e31818781f5. PMC   2605796 . PMID   18766087.
  69. ↑ Lahmeyer HW (June 1982). "Frontal lobe meningioma and depression". The Journal of Clinical Psychiatry. 43 (6): 254–5. PMID   7085582.
  70. ↑ Rao V, Lyketsos C (2000). "Neuropsychiatric sequelae of traumatic brain injury". Psychosomatics. 41 (2): 95–103. doi: 10.1176/appi.psy.41.2.95 . PMID   10749946. S2CID   6717589.
  71. ↑ McHugh T, Laforce R, Gallagher P, Quinn S, Diggle P, Buchanan L (2006). "Natural history of the long-term cognitive, affective, and physical sequelae of mild traumatic brain injury". Brain and Cognition. 60 (2): 209–211. doi:10.1016/j.bandc.2004.09.018. PMID   16646125. S2CID   53190838.
  72. ↑ Legome E. 2006. Postconcussive syndrome. eMedicine.com. Accessed January 1, 2007.
  73. ↑ Schnadower D, Vazquez H, Lee J, Dayan P, Roskind CG (2007). "Controversies in the evaluation and management of minor blunt head trauma in children". Current Opinion in Pediatrics. 19 (3): 258–264. doi:10.1097/MOP.0b013e3281084e85. PMID   17505183. S2CID   20231463.
  74. ↑ Bigler ED (2008). "Neuropsychology and clinical neuroscience of persistent post-concussive syndrome". Journal of the International Neuropsychological Society. 14 (1): 1–22. doi: 10.1017/S135561770808017X . PMID   18078527.
  75. ↑ Evans RW (2004). "Post-traumatic headaches". Neurologic Clinics. 22 (1): 237–249. doi:10.1016/S0733-8619(03)00097-5. PMID   15062537. S2CID   18249136.
  76. ↑ Iverson GL (May 2006). "Misdiagnosis of the persistent postconcussion syndrome in patients with depression". Archives of Clinical Neuropsychology. 21 (4): 303–10. doi: 10.1016/j.acn.2005.12.008 . PMID   16797916.
  77. ↑ Archiniegas DB, Lauterbach EC, Anderson KE, Chow TW, et al. (2005). "The differential diagnosis of pseudobulbar affect (PBA). Distinguishing PBA among disorders of mood and affect. Proceedings of a roundtable meeting". CNS Spectr. 10 (5): 1–16. doi:10.1017/S1092852900026602. PMID   15962457. S2CID   45811704.
  78. ↑ Moore SR, Gresham LS, Bromberg MB, Kasarkis EJ, Smith RA (1997). "A self report measure of affective lability". J Neurol Neurosurg Psychiatry. 63 (1): 89–93. doi:10.1136/jnnp.63.1.89. PMC   2169647 . PMID   9221973.
  79. ↑ R J Siegert; D A Abernethy (2004). "Depression in multiple sclerosis: a review". J Neurol Neurosurg Psychiatry. 76 (4): 469–475. doi:10.1136/jnnp.2004.054635. PMC   1739575 . PMID   15774430.
  80. ↑ Smoking Linked to Increased Depression Risk / Medscape
  81. ↑ Iwasaki M, Akechi T, Uchitomi Y, Tsugane S (April 2005). "Cigarette Smoking and Completed Suicide among Middle-aged Men: A Population-based Cohort Study in Japan". Annals of Epidemiology. 15 (4): 286–92. doi:10.1016/j.annepidem.2004.08.011. PMID   15780776.
  82. ↑ Miller M, Hemenway D, Rimm E (May 2000). "Cigarettes and suicide: a prospective study of 50,000 men". American Journal of Public Health. 90 (5): 768–73. doi:10.2105/AJPH.90.5.768. PMC   1446219 . PMID   10800427.
  83. ↑ Hemenway D, Solnick SJ, Colditz GA (February 1993). "Smoking and suicide among nurses". American Journal of Public Health. 83 (2): 249–51. doi:10.2105/AJPH.83.2.249. PMC   1694571 . PMID   8427332.
  84. ↑ Thomas Bronischa; Michael Höflerab; Roselind Liebac (May 2008). "Smoking predicts suicidality: Findings from a prospective community study". Journal of Affective Disorders. 108 (1): 135–145. doi:10.1016/j.jad.2007.10.010. PMID   18023879.
  85. ↑ Miller M, Hemenway D, Bell NS, Yore MM, Amoroso PJ (June 2000). "Cigarette smoking and suicide: a prospective study of 300,000 male active-duty Army soldiers". American Journal of Epidemiology. 151 (11): 1060–3. doi:10.1093/oxfordjournals.aje.a010148. PMID   10873129.
  86. ↑ Breslau N, Schultz LR, Johnson EO, Peterson EL, Davis GC (March 2005). "Smoking and the Risk of Suicidal Behavior: A Prospective Study of a Community Sample". Archives of General Psychiatry. 62 (3): 328–34. doi:10.1001/archpsyc.62.3.328. PMID   15753246.
  87. ↑ Murphy JM, Horton NJ, Monson RR, Laird NM, Sobol AM, Leighton AH (September 2003). "Cigarette smoking in relation to depression: historical trends from the Stirling County Study". The American Journal of Psychiatry. 160 (9): 1663–9. doi:10.1176/appi.ajp.160.9.1663. PMID   12944343.
  88. ↑ Lembke A, Johnson K, DeBattista C (August 2007). "Depression and smoking cessation: does the evidence support psychiatric practice?". Neuropsychiatr Dis Treat. 3 (4): 487–93. PMC   2655079 . PMID   19300577.
  89. ↑ Aronson KR, Almeida DM, Stawski RS, Klein LC, Kozlowski LT (December 2008). "Smoking is Associated with Worse Mood on Stressful Days: Results from a National Diary Study". Annals of Behavioral Medicine . 36 (3): 259–69. doi:10.1007/s12160-008-9068-1. PMC   2873683 . PMID   19067100.
  90. ↑ Ried LD, Tueth MJ, Handberg E, Kupfer S, Pepine CJ (2005). "A Study of Antihypertensive Drugs and Depressive Symptoms (SADD-Sx) in Patients Treated With a Calcium Antagonist Versus an Atenolol Hypertension Treatment Strategy in the International Verapamil SR-Trandolapril Study (INVEST)". Psychosomatic Medicine. 67 (3): 398–406. doi:10.1097/01.psy.0000160468.69451.7f. PMID   15911902. S2CID   27978181.
  91. ↑ Patten, SB; Love, EJ (1993). "Can drugs cause depression? A review of the evidence". Journal of Psychiatry & Neuroscience. 18 (3): 92–102. PMC   1188504 . PMID   8499431.
  92. ↑ Bremner JD, McCaffery P (February 2008). "The neurobiology of retinoic acid in affective disorders". Progress in Neuro-Psychopharmacology and Biological Psychiatry. 32 (2): 315–31. doi:10.1016/j.pnpbp.2007.07.001. PMC   2704911 . PMID   17707566.
  93. ↑ Debien C, De Chouly De Lenclave MB, Foutrein P, Bailly D (2001). "Alpha-interferon and mental disorders". L'Encéphale. 27 (4): 308–17. PMID   11686052.
  94. ↑ Robert Davies; Ghouse Ahmed; Tegwedd Freer (2000). "Chronic exposure to organophosphates: background and clinical picture". Advances in Psychiatric Treatment. 6 (3): 187–192. doi: 10.1192/apt.6.3.187 .
  95. ↑ Bowden CL (January 2001). "Strategies to reduce misdiagnosis of bipolar depression". Psychiatric Services. 52 (1): 51–5. doi:10.1176/appi.ps.52.1.51. PMID   11141528.
  96. ↑ Matza LS, Rajagopalan KS, Thompson CL, de Lissovoy G (November 2005). "Misdiagnosed patients with bipolar disorder: comorbidities, treatment patterns, and direct treatment costs". The Journal of Clinical Psychiatry. 66 (11): 1432–40. doi:10.4088/jcp.v66n1114. PMID   16420081.
  97. ↑ Akiskal HS, Benazzi F (2006). "The DSM-IV and ICD-10 categories of recurrent [major] depressive and bipolar II disorders: Evidence that they lie on a dimensional spectrum". Journal of Affective Disorders. 92 (1): 45–54. doi:10.1016/j.jad.2005.12.035. PMID   16488021.
  98. ↑ Hvas AM, Juul S; Bech P, Nexø E (2004). "Vitamin B6 Level Is Associated with Symptoms of Depression". Psychotherapy and Psychosomatics. 73 (6): 340–3. doi:10.1159/000080386. PMID   15479988. S2CID   37706794.
  99. ↑ Coppen A, Bolander-Gouaille C (January 2005). "Treatment of depression: time to consider folic acid and vitamin B12". Journal of Psychopharmacology. 19 (1): 59–65. doi:10.1177/0269881105048899. PMID   15671130. S2CID   4828454.
  100. ↑ Rao NP, Kumar NC, Raman BR, Sivakumar PT, Pandey RS (2008). "Role of vitamin B12 in depressive disorder — a case report☆". General Hospital Psychiatry. 30 (2): 185–6. doi:10.1016/j.genhosppsych.2007.09.002. PMID   18291301.
  101. ↑ "Study Links Brain Fatty Acid Levels To Depression". ScienceDaily. Bethesda, MD: American Society For Biochemistry And Molecular Biology. 2005-05-25. Retrieved 2008-01-18.
  102. ↑ Kiecolt-Glaser JK.; et al. (April 2007). "Depressive symptoms, omega-6:omega-3 fatty acids, and inflammation in older adults". Psychosom. Med. 69 (3): 217–224. doi:10.1097/PSY.0b013e3180313a45. PMC   2856352 . PMID   17401057.
  103. ↑ Dinan T, Siggins L, Scully P, O'Brien S, Ross P, Stanton C (January 2009). "Investigating the inflammatory phenotype of major depression: Focus on cytokines and polyunsaturated fatty acids". Journal of Psychiatric Research. 43 (4): 471–6. doi:10.1016/j.jpsychires.2008.06.003. PMID   18640689.
  104. ↑ Lustberg L, Reynolds CF (June 2000). "Depression and insomnia: questions of cause and effect". Sleep Medicine Reviews. 4 (3): 253–262. doi:10.1053/smrv.1999.0075. PMID   12531168.
  105. ↑ Wilson, S. J.; et al. (2 September 2010). "British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders". J Psychopharm. 24 (11): 1577–601. doi:10.1177/0269881110379307. PMID   20813762. S2CID   16823040.
  106. ↑ Skidmore FM, Drago V, Foster PS, Heilman KM (2009). "Bilateral restless legs affecting a phantom limb, treated with dopamine agonists". J Neurol Neurosurg Psychiatry. 80 (5): 569–70. doi:10.1136/jnnp.2008.152652. PMID   19372293. S2CID   23584726.
  107. ↑ Lee HB, Hening WA, Allen RP, et al. (2008). "Restless Legs Syndrome is Associated with DSM-IV Major Depressive Disorder and Panic Disorder in the Community". Journal of Neuropsychiatry. 20 (1): 101–5. doi:10.1176/appi.neuropsych.20.1.101. PMID   18305292.
  108. ↑ Harris M, Glozier N, Ratnavadivel R, Grunstein RR (December 2009). "Obstructive sleep apnea and depression". Sleep Medicine Reviews. 13 (6): 437–44. doi:10.1016/j.smrv.2009.04.001. hdl: 2328/26226 . PMID   19596599.
  109. ↑ Dagan Y (2002). "Circadian rhythm sleep disorders (CRSD)" (PDF). Sleep Med Rev. 6 (1): 45–54. doi:10.1053/smrv.2001.0190. PMID   12531141. Archived from the original (PDF: full text) on 2008-02-27. Retrieved 2007-11-08. Early onset of CRSD, the ease of diagnosis, the high frequency of misdiagnosis and erroneous treatment, the potentially harmful psychological and adjustment consequences, and the availability of promising treatments, all indicate the importance of greater awareness of these disorders.

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