Table 4.
Major Depression | Indications for Further Psychiatric Evaluation |
---|---|
At least one of these must be present: | Evidence of suicidal ideation, inability to care for self or dependent others, or aggressivity/homicidal ideation |
Depressed mood | |
Loss of interest or pleasure in most or all activities | |
Four or more of the following must be present: |
Failure to respond to or is intolerant of initial treatment trial |
Insomnia or hypersomnia | Patient or clinician interested in modalities requiring specialty expertise (psychotherapy or electroconvulsive therapy, transcranial magnetic stimulation) |
Change in appetite or weight | |
Psychomotor retardation or agitation | |
Low energy | |
Poor concentration | |
Thoughts of worthlessness or guilt | Psychotic symptoms present |
Recurrent thoughts about death or suicide | History of bipolar disorder or psychotic disorder |
Significant psychiatric comorbidity (anxiety disorders, substance use, cognitive disorder) |
|
Unclear diagnosis of depression |