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Depression, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Major depression: 
  • Depressed mood and associated signs and symptoms lasting more than 2 wk

  • Significant morbidity and mortality, including risk of suicide

  • Often coexists with other medic...

Diagnosis

Signs and Symptoms

  • 5 or more symptoms for at least 2 wk. (One of the symptoms must be depressed mood or loss of interest or pleasure):

    • Depressed mood

    • Diminished interest or pleasure

    • Change in ap...

Treatment

Pre-Hospital

  • Ensure safety of patient and providers

  • Understand local laws for involuntary commitment to hospital

Initial Stabilization/Therapy

  • Safety: Assess risk of suicide, violence

  • General med...

Follow-Up

Disposition

Admission Criteria

  • Patient is suicidal or at high risk for suicide. See “Suicide, Risk Evaluation

  • Minimal or unreliable social supports

  • Symptoms so severe that continual observation...

Pearls and Pitfalls

  • Patients with depression experience significant morbidity and may present a risk of self-harm

  • Consider other conditions that mimic depression; also coexisting psychiatric and medica...

Additional Reading

  • American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder, third edition. Am J Psychiatry.  2010;167(suppl 10):1–152.

  • Bel...

Codes

ICD9

  • 296.20 Major depressive affective disorder, single episode, unspecified

  • 296.24 Major depressive affective disorder, single episode, severe, specified as with psychotic behavior

  • 296.30 Major de...

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