eMedicine Specialties > Emergency Medicine > Psychosocial
Depression and Suicide: Differential Diagnoses & Workup
Updated: Jun 23, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Posttraumatic stress disorders
Postpartum depression
Postpartum psychosis
Sheehan syndrome
Chronic fatigue syndrome
Liver failure
Vitamin deficiency
Medication adverse effects
Medication abuse/overdose
Withdrawal from abused substances
Apathetic thyrotoxicosis (in elderly persons)
Workup
Laboratory Studies
- Depression is a clinical diagnosis. Laboratory tests are primarily used to rule out other diagnoses. Consider the following laboratory tests:
- Complete blood count (CBC)
- Electrolytes, including calcium, phosphate, and magnesium
- BUN and creatinine
- Calcium
- Serum toxicology screen
- Thyroid function tests
- Thyroid-stimulating hormone (TSH) level
Imaging Studies
- CT scan or MRI of brain if OBS or hypopituitarism is included in the differential
Other Tests
- Electrocardiogram (ECG): Diagnosis of arrhythmia, particularly heart block
- Electroencephalogram (EEG)
- Certain psychometric tests can make a diagnosis of depressive disorders with reasonable clinical certainty; however, these are not generally available in emergency departments.
- Zung Self-Rating Depression Scale
- Beck Depression Inventory (BDI)
- Criteria for Epidemiologic Studies-Depression (CES-D) scale
- Studies - Depression scale
- Children's Depression Inventory (CDI)
- Yesavage Geriatric Depression Scale
More on Depression and Suicide |
| Overview: Depression and Suicide |
 Differential Diagnoses & Workup: Depression and Suicide |
| Treatment & Medication: Depression and Suicide |
| Follow-up: Depression and Suicide |
| References |
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References
Angst J, Angst F, Stassen HH. Suicide risk in patients with major depressive disorder. J Clin Psychiatry. 1999;60 Suppl 2:57-62; discussion 75-6, 113-6. [Medline].
Apter A, Horesh N, Gothelf D, et al. Relationship between self-disclosure and serious suicidal behavior. Compr Psychiatry. Jan-Feb 2001;42(1):70-5. [Medline].
Gliatto MF, Rai AK. Evaluation and treatment of patients with suicidal ideation. Am Fam Physician. Mar 15 1999;59(6):1500-6. [Medline].
Harwitz D, Ravizza L. Suicide and depression. Emerg Med Clin North Am. May 2000;18(2):263-71, ix. [Medline].
Mann JJ, Apter A, Bertolote J, et al. Suicide prevention strategies: a systematic review. JAMA. Oct 26 2005;294(16):2064-74. [Medline].
Oquendo MA, Malone KM, Mann JJ. Suicide: risk factors and prevention in refractory major depression. Depress Anxiety. 1997;5(4):202-11. [Medline].
Osvath P, Voros V, Fekete S. Life events and psychopathology in a group of suicide attempters. Psychopathology. Jan-Feb 2004;37(1):36-40. [Medline].
Rives W. Emergency department assessment of suicidal patients. Psychiatr Clin North Am. Dec 1999;22(4):779-87, viii. [Medline].
SK Goldsmith, TC Pellmar, AM Kleinman. Reducing Suicide: A National Imperative. Institute of Medicine Monograph. National Academies Press 2002;[Full Text].
Verona E, Sachs-Ericsson N, Joiner TE. Suicide attempts associated with externalizing psychopathology in an epidemiological sample. Am J Psychiatry. Mar 2004;161(3):444-51. [Medline].
Further Reading
Keywords
depressive illness, mood disorder, suicidal, suicidality, suicide ideation, suicide attempt, suicide attempts, self-destructive acts, self-murder, suicide gesture, major depressive disorder, MDD, unipolar depression, unipolar affective disorder, serotonin, norepinephrine, dopamine, selective serotonin reuptake inhibitors, SSRIs, tricyclic antidepressants, TCAs, norepinephrine, NE, dopamine, DA, suicide, seasonal affective disorder, SAD, antidepressants, lithium, psychotherapy, substance abuse, alcohol abuse, drug abuse
