抑郁症英文介绍

DepressionTheMentalIllnesswhatisdepressionDepressionisamentalhealthdisorder,apsychiatriccondition，characterizedbysadness,lossofinterestorpleasure,feelingsofguiltorlowself-worth,disturbedsleeporappetite,feelingsoftiredness,andpoorconcentration.Specifically,itisamooddisordercharacterizedbypersistentlylowmoodinwhichthereisafeelingofsadnessandlostofinterest.Depressionisdifferentfromthefluctuationsinmoodthatweallexperienceasapartofanormalandhealthylife.Temporaryemotionalresponsestothechallengesofeverydaylifedonotconstitutedepression.AccordingtotheUSCentersforDiseasePreventionandControl(CDC),8%ofpeopleovertheageof12yearshasdepressioninanytwo-weekperiod.TheWorldHealthOrganization(WTO)putsdepressionatthetopofthelist-itisthemostcommonillnessworldwideandtheleadingceaseofdisability.Theorganizationestimatesthat350millionpeoplearoundtheworldareaffectedbydepression.MajorDepressivedisorderMajordepressivedisorder(MDD),alsoknownsimplyasdepression,isamentaldisordercharacterizedbyatleasttwoweeksoflowmoodthatispresentacrossmostsituations.Itisoftenaccompaniedbylowself-esteem,lossofinterestinnormallyenjoyableactivities,lowenergy,andpainwithoutaclearcause.Peoplemayalsooccasionallyhavefalsebeliefsorseeorhearthingsthatotherscannot.Somepeoplehaveperiodsofdepressionseparatedbyyearsinwhichtheyarenormalwhileothersnearlyalwayshavesymptomspresent.Majordepressivedisordercannegativelyaffectsaperson'sfamily,workorschoollife,sleepingoreatinghabits,andgeneralhealth.Between2-7%ofadultswithmajordepressiondiebysuicide,andupto60%ofpeoplewhodiebysuicidehaddepressionoranothermooddisorder.Thecauseisbelievedtobeacombinationofgenetic,environmental,andpsychologicalfactors.Riskfactorsincludeafamilyhistoryofthecondition,majorlifechanges,certainmedications,chronichealthproblems,andsubstanceabuse.About40%oftheriskappearstoberelatedtogenetics.Thediagnosisofmajordepressivedisorderisbasedontheperson'sreportedexperiencesandamentalstatusexamination.Thereisnolaboratorytestformajordepression.Testing,however,maybedonetoruleoutphysicalconditionsthatcancausesimilarsymptoms.Majordepressionshouldbedifferentiatedfromsadnesswhichisanormalpartoflifeandislesssevere.TheUnitedStatesPreventiveServicesTaskForce(USPSTF)recommendsscreeningfordepressionamongthoseovertheage12,whileapriorCochranereviewfoundinsufficientevidenceforscreening.Typically,peoplearetreatedwithcounsellingandantidepressantmedication.Medicationappearstobeeffective,buttheeffectmayonlybesignificantinthemostseverelydepressed.Itisunclearwhethermedicationsaffecttheriskofsuicide.Typesofcounsellingusedincludecognitivebehavioraltherapy(CBT)andinterpersonaltherapy.Ifothermeasuresarenoteffectiveelectroconvulsivetherapy(ECT)maybetried.Hospitalizationmaybenecessaryincaseswithariskofharmtoselfandmayoccasionallyoccuragainstaperson'swishes.Majordepressivedisorderaffectedapproximately253million(3.6%)ofpeoplein2013.Thepercentageofpeoplewhoareaffectedatonepointintheirlifevariesfrom7%inJapanto21%inFrance.Lifetimeratesarehigherinthedevelopedworld(15%)comparedtothedevelopingworld(11%).Itcausesthesecondmostyearslivedwithdisabilityafterlowbackpain.Themostcommontimeofonsetisinapersonintheir20sand30s.Femalesareaffectedabouttwiceasoftenasmales.TheAmericanPsychiatricAssociationadded"majordepressivedisorder"totheDiagnosticandStatisticalManualofMentalDisorders(DSM-III)in1980.ItwasasplitofthepreviousdepressiveneurosisintheDSM-IIwhichalsoencompassedtheconditionsnowknownasdysthymiaandadjustmentdisorderwithdepressedmood.Thosecurrentlyorpreviouslyaffectedmaybestigmatized.Whatarethesignsandsymptomsofdepression?depressionmaybetriggeredbystressfullifeevents,otherillnesses,certaindrugsormedications,orinheritedtraits.althoughcausesofdepressionarenotentirelyunderstood,weknowitislinkedtoanimbalanceinbrainchemistry.oncetheimbalanceiscorrected,symptomsofdepressiongenerallyimprovePeoplewithdepressiveillnessesdonotallexperiencethesamesymptoms.Theseverity,frequencyanddurationofsymptomswillvarydependingontheindividualandhisorherparticularillness.Symptomsinclude:Persistentsad,anxiousor"empty"feelingsFeelingsofhopelessnessand/orpessimismFeelingsofguilt,worthlessnessand/orhelplessnessIrritability,restlessnessLossofinterestinactivitiesorhobbiesoncepleasurable,includingsexFatigueanddecreasedenergyDifficultyconcentrating,rememberingdetailsandmakingdecisionsInsomnia,early-morningwakefulness,orexcessivesleepingOvereating,orappetitelossThoughtsofsuicide,suicideattemptsPersistentachesorpains,headaches,crampsordigestiveproblemsthatdonoteaseevenwithtreatmentAllofthesesymptomscaninterferewithyourqualityoflife.Evenifyoudon'thavemajordepression,ifyouhaveexperienceafewofthesesymptomsforatleasttwoweeksyoumayhavelesssevereformofdepressionthatstillrequirestreatment.thesymptomsofslightandmajordepressionDepressionisamedicalconditioninwhichapersonfeelsverysadandanxiousandoftenhasphysicalsymptoms.Slightdepressioncouldbeaportionofmajordepression,sothecriteriaforthisdiseaseareimportanttoconsiderandexamineforpeoplewiththeproblem.Ifthedepressionisonlyminor,itwillnothaveallofthecomponentsofmajordepressionandthereforewouldbetreateddifferentlyfromthemoreseriousversionofthedisease.ThemostcommondiagnosticcriteriaareencapsulatedinthemnemonicdeviceSIGECAPS.Theyareintheorderoftheletters,Sleepproblems,lackofInterest,Guiltyfeelings,lackofEnergy,problemswithConcentration,Appetiteandweightdisturbances,Psychomotorretardation,andSuicidalthoughtsoractions.Ifapersonhasfiveorsixitemsinthiscriteriaitisverylikelythattheyhavemajordepressionandtheyshouldbetreatedforit.Iftheyonlyhaveoneortwoofthemtheymighthavealessseriousversionofthedisease,butitstillmayrequiretreatment.Theonlydifferenceisthatitcouldbemoreminor.Byaskingaboutthesedifferentsymptoms,peopleperformabasicdiagnosistesttoevaluatethemselvesortheirpatients.Thesymptomsofserioustoslightdepressionmaybeverydebilitatingtoapatientandidentificationoftheproblemisthefirststeptoafullrecovery.Theconditionofdepressivedisordersisprevalentthroughallwalksoflifeanditisexpectedthatthemajorityofpersonswillexperiencesymptomsofdepressionatleastonceinthecourseoftheirlife.However,sincemostpeopleexperiencethesesymptomsatsomepoint,extendedresearchhasbeendonetodeterminethebestwaytotreatthesespecificconditionsandmanysolutionsareavailabletosufferers.Tothetissues,whichraisesthecarbondioxidelevel,causinggeneralDepression.AssociatedconditionsMajordepressionfrequentlyco-occurswithotherpsychiatricproblems.The1990—2NationalComorbiditySurvey(US)reportsthathalfofthosewithmajordepressionalsohavelifetimeanxietyanditsassociateddisorderssuchasgeneralizedanxietydisorder.Anxietysymptomscanhaveamajorimpactonthecourseofadepressiveillness,withdelayedrecovery,increasedriskofrelapse,greaterdisabilityandincreasedsuicideattempts.AmericanneuroendocrinologistRobertSapolskysimilarlyarguesthattherelationshipbetweenstress,anxiety,anddepressioncouldbemeasuredanddemonstratedbiologically.Thereareincreasedratesofalcoholanddrugabuseandparticularlydependence,andaroundathirdofindividualsdiagnosedwithADHDdevelopcomorbiddepression.Post-traumaticstressdisorderanddepressionoftenco-occur.Depressionmayalsocoexistwithattentiondeficithyperactivitydisorder(ADHD),complicatingthediagnosisandtreatmentofboth.Depressionandpainoftenco-occur.Oneormorepainsymptomsarepresentin65%ofdepressedpatients,andanywherefrom5to85%ofpatientswithpainwillbesufferingfromdepression,dependingonthesetting;thereisalowerprevalenceingeneralpractice,andhigherinspecialtyclinics.Thediagnosisofdepressionisoftendelayedormissed,andtheoutcomeworsens.Theoutcomecanalsoworsenifthedepressionisnoticedbutcompletelymisunderstood.Depressionisalsoassociatedwitha1.5-to2-foldincreasedriskofcardiovasculardisease,independentofotherknownriskfactors,andisitselflinkeddirectlyorindirectlytoriskfactorssuchassmokingandobesity.Peoplewithmajordepressionarelesslikelytofollowmedicalrecommendationsfortreatingandpreventingcardiovasculardisorders,whichfurtherincreasestheirriskofmedicalcomplications.Inaddition,cardiologistsmaynotrecognizeunderlyingdepressionthatcomplicatesacardiovascularproblemundertheircare.ManagementThethreemostcommontreatmentsfordepressionarepsychotherapy,medication,andelectroconvulsivetherapy.Psychotherapyisthetreatmentofchoice(overmedication)forpeopleunder18.TheUKNationalInstituteforHealthandCareExcellence(NICE)2004guidelinesindicatethatantidepressantsshouldnotbeusedfortheinitialtreatmentofmilddepression,becausetherisk-benefitratioispoor.Theguidelinesrecommendthatantidepressantstreatmentincombinationwithpsychosocialinterventionsshouldbeconsideredfor:PeoplewithahistoryofmoderateorseveredepressionThosewithmilddepressionthathasbeenpresentforalongperiodAsasecondlinetreatmentformilddepressionthatpersistsafterotherinterventionsAsafirstlinetreatmentformoderateorseveredepressionLifestylePhysicalexerciseisrecommendedformanagementofmilddepression,andhasamoderateeffectonsymptoms.Exercisehasalsobeenfoundtobeeffectivefor(unipolar)majordepression.Itisequivalenttotheuseofmedicationsorpsychologicaltherapiesinmostpeople.Intheolderpeopleitdoesappeartodecreasedepression.Exercisemayberecommendedtopeoplewhoarewilling,motivated,andphysicallyhealthyenoughtoparticipateinanexerciseprogramastreatment.Thereisasmallamountofevidencethatskippinganight'ssleepmayimprovedepressivesymptoms,withtheeffectsusuallyshowingupwithinaday.Thiseffectisusuallytemporary.Besidessleepiness,thismethodcancauseasideeffectofmaniaorhypomania.InobservationalstudiessmokingcessationhasbenefitsindepressionaslargeasorlargerthanthoseofmedicationsRangeMajordepressivedisorderaffectsapproximately253millionpeoplein2013(3.6%oftheglobalpopulation).Thepercentageofpeoplewhoareaffectedatonepointintheirlifevariesfrom7%inJapanto21%inFrance.Inmostcountriesthenumberofpeoplewhohavedepressionduringtheirlivesfallswithinan8—18%range.InNorthAmerica,theprobabilityofhavingamajordepressiveepisodewithinayear-longperiodis3-5%formalesand8-10%forfemales.Majordepressiontobeabouttwiceascommoninwomenasinmen,althoughitisunclearwhythisisso,andwhetherfactorsunaccountedforarecontributingtothis.Therelativeincreaseinoccurrenceisrelatedtopubertaldevelopmentratherthanchronologicalage,reachesadultratiosbetweentheagesof15and18,andappearsassociatedwithpsychosocialmorethanhormonalfactors.Depressionisamajorcauseofdisabilityworldwide.Peoplearemostlikelytodeveloptheirfirstdepressiveepisodebetweentheagesof30and40,andthereisasecond,smallerpeakofincidencebetweenages50and60.Theriskofmajordepressionisincreasedwithneurologicalconditionssuchasstroke,Parkinson'sdisease,ormultiplesclerosis,andduringthefirstyearafterchildbirth.Itisalsomorecommonaftercardiovascularillnesses,andisrelatedmoretoapooroutcomethantoabetterone.Studiesconflictontheprevalenceofdepressionintheelderly,butmostdatasuggestthereisareductioninthisagegroup.Depressivedisordersaremorecommontoobserveinurbanthaninruralpopulationandtheprevalenceisingroupswithstrongersocioeconomicfactorsi.e.homelessness.