Mental Health Book

Disease Complications

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Depression Management

Aka: Depression Management, Depression Counseling, Psychotherapy for Depression, Cognitive Behavioral Therapy for Depression
  1. See Also
    1. Depression Medical Management
    2. See Antidepressant
    3. See Antidepressant Adverse Effects
    4. See Psychiatric Medications in Pregnancy
    5. Electroconvulsive Therapy
  2. Management: Psychotherapy - Reassurance and listening
    1. Instill hope
    2. Consider Cork Analogy
      1. Think of self as cork under water
      2. No matter how much people or events push you under
      3. Eventually you will pop up
  3. Management: Psychotherapy - Reinforce Positive Behaviors
    1. Exercise (may increase energy and self esteem)
      1. Likely effective adjunct, although variable evidence (needs more high quality studies)
      2. Blumenthal (1999) Arch Intern Med 159:2349-56 [PubMed]
      3. Cooney (2014) JAMA 311(23): 2432-33 [PubMed]
      4. Dunn (2005) Am J Prev Med 28:1-8 [PubMed]
    2. Yoga
      1. Effective in the treatment of Major Depression
      2. Cramer (2017) J Affect Disord 213:70-77 [PubMed]
    3. Mindfulness Based Interventions
      1. Effective in the treatment of Major Depression
      2. Goldberg (2018) Clin Psychol Rev 59: 52-60 [PubMed]
    4. Healthy Diet
    5. Attending Counseling
    6. Antidepressant Compliance
      1. Reassure that these are not habit forming
      2. Reassure that these are not forever
      3. Establish a therapeutic alliance
    7. Schedule pleasurable activities (esp. with people)
    8. Repair relationships with family and friends
    9. Consider keeping a journal
  4. Management: Psychotherapy - Discourage Negative Behaviors
    1. Challenge negative thoughts
    2. Sleep disturbance
    3. Stress in relationships and work
    4. Poor diet or nutrition
    5. Alcohol use or Alcohol Abuse
    6. Medications that worsen depression (Beta Blockers)
  5. Management: Psychotherapy - Educate family and patient
    1. Greatest risk of Suicide is in early treatment
  6. Management: Cognitive Behavioral Therapy
    1. Efficacy
      1. At least as effect as pharmacotherapy
      2. Wampold (2002) J Affect Disord 68:159-65 [PubMed]
    2. Summary of Process
      1. Recognize that some Perceptions of reality are false
      2. False Perceptions lead to negative thoughts
      3. Learn to identify negative thoughts as they occur
      4. Replace distorted thoughts with alternatives
      5. Reframe central beliefs about world and self-image
    3. Techniques
      1. Keep a Thought Journal
        1. Identify specific stressful situations
          1. Example: Meeting a new person
        2. Characterize associated mood and automatic reaction
          1. Example: I am anxious - they will hate me
        3. Identify reasons for negative thoughts
          1. Example: Noone speaks with me at parties
        4. Identify counter-arguments
          1. Example: I have close friends who care about me
        5. Substitute negative thought with alternative
          1. Example: I am likeable - be myself
      2. Set goals and activities (example follows)
        1. Goal: Exercise every day, this improves self-esteem
        2. Start: Next thursday, before work
        3. Obstacles: Early wake-up
        4. Strategies to overcome obstacles
          1. Be in bed by 10 pm, with clothes set out for AM
        5. Progress
          1. Jan 4: Arrived gym 20 minutes late, short jog
          2. Jan 5: Overslept, missed workout, bad day
          3. Jan 6: Swam for 40 minutes, feel great
  7. Management: Adjuncts
    1. Audio tape based Patient Education
      1. Small British study of "Coping with Depression" tape
      2. Found to effective adjunct to Depression Management
      3. Blenkiron (2001) Br J Gen Pract 51:366-70 [PubMed]
    2. Website based cognitive-behavioral management
      1. Mood Gym
      2. Effective in Major Depression
        1. Christensen (2004) BMJ 328:265-9 [PubMed]
  8. Resources
    1. See Depression Resources
  9. References
    1. Rupke (2006) Am Fam Physician 73(1):83-86 [PubMed]
    2. Saeed (2019) Am Fam Physician 99(10): 620-7 [PubMed]
    3. Scott (1996) J Affect Disord 37:1-11 [PubMed]

Cognitive Therapy (C0009244)

Definition (NCI) A type of psychotherapy utilized to treat different forms of mental disorders.The treatment involves the identification of unhelpful or destructive patterns of thinking and behaviors and the subsequent replacement with behaviors that are beneficial and constructive.
Definition (NCI_NCI-GLOSS) A type of psychotherapy that helps patients change their behavior by changing the way they think and feel about certain things. It is used to treat mental, emotional, personality, and behavioral disorders.
Definition (MSH) A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior.
Definition (PSY) Directive therapy based on the belief that the way one perceives and structures the world determines one's feelings and behavior. Treatment aims at altering cognitive schema and hence permitting the patient to change his/her distorted self-view and world view.
Definition (PSY) An integrated approach to psychotherapy that combines the techniques of cognitive and behavior therapy.
Definition (CSP) involves identifying and changing specific cognitive processes as they relate to problems of emotions and behavior; based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior; directed toward learning through practice of specific skills which have direct relevance to the present problem.
Definition (NIC) Interventions to reinforce or promote desirable cognitive functioning or alter undesirable cognitive functioning
Concepts Therapeutic or Preventive Procedure (T061)
MSH D015928
ICD10 96101-00
SnomedCT 228553007, 151618003, 390657008, 389923006, 183383008, 304891004, 228557008
English Behavior Therapies, Cognitive, Behavior Therapy, Cognitive, Cognition Therapies, Cognition Therapy, Cognitive Behavior Therapies, Cognitive Behavior Therapy, Cognitive Psychotherapies, Cognitive Psychotherapy, Cognitive Therapies, Psychotherapies, Cognitive, Psychotherapy, Cognitive, Therapies, Cognition, Therapies, Cognitive, Therapies, Cognitive Behavior, Therapy, Cognition, Therapy, Cognitive, Therapy, Cognitive Behavior, Cognitive Therapy, COGNITIVE PSYCHOTHER, THER COGNITIVE BEHAVIOR, BEHAVIOR THER COGNITIVE, COGNITIVE THER, THER COGNITION, COGNITION THER, PSYCHOTHER COGNITIVE, THER COGNITIVE, COGNITIVE BEHAVIOR THER, Cognitive-behavior ther appro, Cognitive-behaviour ther appro, CBT-Cognitiv-behavior therapy, Cognitve & behavioral therapy, CBT-Cognitiv-behaviour therapy, Cognitve & behavioural therapy, CT, cognitive behavior modification, cognitive behavioral therapy (treatment), cognitive behavioral therapy, rnox cognition (treatment), rnox cognition, Cognitive behavior therapy, Cognitive behaviour therapy, cognitive therapy, cognitive and behavioral therapy, therapy behavior cognitive, therapy cognitive, behaviour cognitive therapy, cognitive behaviour therapy, cognitive therapies, behavioral cognitive therapy, cognitive behavior therapy, cognitive psychotherapy, Cognitive psychotherapy, Cognitive Behavioral Therapies, Therapies, Cognitive Behavioral, Cognitive Behavioral Therapy, Behavioral Therapies, Cognitive, Behavioral Therapy, Cognitive, Therapy, Cognitive Behavioral, Cognitive - behaviour therapy (regime/therapy), CBT, Psychotherapy - cognitive, Cognitive approach, Cognitive therapy approach, CBT - Cognitive - behavior therapy, Cognitive - behavior therapy, Cognitive and behavioral therapy, CBT - Cognitive - behaviour therapy, Cognitive - behaviour therapy, Cognitive and behavioural therapy, Cognitive therapy, Cognitive-behavioral therapy approach, Cognitive-behavioural therapy approach, Cognitive - behavior therapy (regime/therapy), Cognitive and behavioral therapy (regime/therapy), Cognitive therapy (regime/therapy), Psychotherapy - cognitive (regime/therapy), Cognitive - behavior therapy (procedure), Cognitive and behavioral therapy (procedure), Cognitive therapy (procedure), Psychotherapy - cognitive (procedure), Cognitive-behaviour therapy, cognitive behavioural therapy, Cognitive behavioral therapy, Cognitive behavioural therapy
Spanish psicoterapia cognitiva, Psicoterapia congnitiva, abordaje cognitivo, psicoterapia - cognitiva (régimen/tratamiento), psicoterapia - cognitiva, terapia cognitiva (régimen/tratamiento), terapia cognitiva y conductual (régimen/tratamiento), terapia cognitiva y conductual, terapia cognitiva, tratamiento con terapia cognitivo-conductual (régimen/tratamiento), tratamiento con terapia cognitivo-conductual, Psicoterapia Cognitiva, Terapia Cognitiva, Terapia Conductista Cognitiva
Dutch cognitieve psychotherapie, Cognitieve therapie, Gedragstherapie, cognitieve, Psychotherapie, cognitieve
German kognitive Psychotherapie, Kognitive Therapie, Psychotherapie, kognitive, Verhaltenstherapie, kognitive
Portuguese Psicoterapia cognitiva, Psicoterapia Cognitiva, Terapia Cognitiva, Terapia Comportamental Cognitiva
Swedish Kognitiv terapi
Japanese ニンチシンリリョウホウ, 行動療法-認知, 認知療法, 認知心理療法, 認知行動療法, 心理療法-認知
Finnish Kognitiivinen psykoterapia
Italian Terapia cognitivo-comportamentale, Terapia della cognizione, Psicoterapia cognitiva, Terapia cognitiva
Czech Kognitivní psychoterapie, kognitivně behaviorální terapie, kognitivní terapie, kognitivně-behaviorální terapie, KBT
Polish Terapia poznawczo-behawioralna, Psychoterapia poznawcza, Terapia poznawcza, Terapia zachowania
Hungarian Kognitív pszichoterápia
Norwegian Kognitiv atferdsterapi, Atferdsterapi, kognitiv
French TCC (Thérapie Cognitivo-Comportementale), Thérapie cognitivo-comportementale, Thérapie cognito-comportementale, Psychothérapie cognitive, Thérapie cognitive comportementale, Thérapie cognitive
Derived from the NIH UMLS (Unified Medical Language System)

Counseling (C0010210)

Definition (CCC) Actions performed to provide advice or instruction to help another
Definition (SCTSPA) Procedimiento psicosocial que implica escuchar, reflexionar, etc., para facilitar el reconocimiento de un curso de acción / solución
Definition (SNOMEDCT_US) Psychosocial procedure that involves listening, reflecting, etc. to facilitate recognition of course of action / solution.
Definition (NCI) The act of receiving professional guidance in resolving personal conflicts and emotional problems.
Definition (NCI_NCI-GLOSS) The process by which a professional counselor helps a person cope with mental or emotional distress, and understand and solve personal problems.
Definition (MSH) The giving of advice and assistance to individuals with educational or personal problems.
Definition (PSY) Conceptually broad term referring to a form of helping process which involves giving advice and information, in order to assist individuals or groups in coping with their problems. Use a more specific term if possible.
Definition (CSP) the use of psychological methods in testing the interests of and giving professional guidance to individuals.
Definition (NIC) Use of an interactive helping process focusing on the needs, problems, or feelings of the patient and significant others to enhance or support coping, problem solving, and interpersonal relationships
Concepts Health Care Activity (T058)
MSH D003376
SnomedCT 170975000, 170984000, 148198002, 69197005, 360268008, 148199005, 170974001, 148207006, 129441002, 409063005
English Counseling, Counseling - general, Counseling - general NOS, Counselling - general, Counselling - general NOS, Counselling - general (context-dependent category), Counselling - general NOS (context-dependent category), Counselling - general (situation), Counselling - general NOS (situation), counseling service, rnrx counseling service (treatment), rnrx counseling service, counseling services, counselling, counseling therapy, Counseling Service, counseling, preventive medicine services: counseling, counseling (treatment), Counseling - general (situation), Counselling - general (procedure), Counselling - general NOS (procedure), Counseling - general NOS (situation), Counselling - action (qualifier value), Counseling - action (qualifier value), Counseling - action, Counselling - action, Counselling, Counselling service, Counseling (regime/therapy), Counseling (procedure)
Spanish asesoramiento (procedimiento), asesoramiento (acción), asesoramiento - general, SAI (categoría dependiente del contexto), asesoramiento (régimen/terapia), asesoramiento - general (categoría dependiente del contexto), Consejo, asesoramiento - general (situación), asesoramiento - general, SAI, Counselling - general NOS, asesoramiento - general, asesoramiento - general, SAI (situación), asesoramiento - general, SAI (procedimiento), asesoramiento - acción (calificador), asistencia psicológica (acción), orientación (acción), orientación - acción (calificador), orientación - acción, psicoterapia (acción), asesoramiento
Swedish Rådgivning
Czech poradenství
Finnish Neuvonta
Japanese カウンセリング, 相談(心理学)
Italian Counselling, Counseling
Polish Poradnictwo, Poradnictwo psychiatryczne, Telefon zaufania, Poradnictwo psychologiczne
Norwegian Rådgivning
Portuguese Conselho, Aconselhamento
French Conseil
German Beratung, Richtungsweisende Beratung
Dutch Voorlichting en advies, niet gespecificeerd
Derived from the NIH UMLS (Unified Medical Language System)

Psychotherapy (C0033968)

Definition (NCI) A method of treating disease, esp. psychic disorders, by mental rather than pharmacological means (e.g., suggestion, re-education, hypnotism, and psychoanalysis). (Taber's)
Definition (NCI_NCI-GLOSS) Treatment of mental, emotional, personality, and behavioral disorders using methods such as discussion, listening, and counseling.
Definition (MSH) A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication.
Definition (CSP) treatment of emotional, behavioral, personality, and psychiatric disorders based primarily upon verbal or nonverbal communication and interventions with the patient.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D011613
ICD10 96099-00
SnomedCT 151615000, 183380006, 75516001
CPT 1021137
English Psychotherapies, PSYCHOTHER, psychotherapeutic technique, psychotherapies, psychotherapy, Psychotherapy Services and Procedures, talk therapy, Psychotherapy (regime/therapy), Psychotherapy, NOS, Psychotherapy (regime/therapy)(procedure), Psychotherapy
Japanese 心理療法, シンリリョウホウ
Swedish Psykoterapi
Czech psychoterapie, Psychoterapie
Finnish Psykoterapia
Polish Psychoterapia
Hungarian Pszichoterápia
Norwegian Psykoterapi
Spanish psicoterapia (procedimiento), psicoterapia (régimen/tratamiento), psicoterapia, Psicoterapia
Dutch psychotherapie, Psychotherapie
French Psychothérapie
German Psychotherapie
Italian Psicoterapia
Portuguese Psicoterapia
Derived from the NIH UMLS (Unified Medical Language System)

Major Depressive Disorder (C1269683)

Definition (MSH) Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.
Definition (PSY) Affective disorder marked by dysphoric mood, inactivity, lack of interest, insomnia, feelings of worthlessness, diminished ability to think, and thoughts of suicide. Use DEPRESSION (EMOTION) for nonclinical depression.
Definition (CSP) one or more periods of depression in the absence of history of manic or hypomanic episodes; chronic type lasts 2 or more years; melancholic type is more severe, has vegetative signs, and responds well to somatic therapy.
Concepts Mental or Behavioral Dysfunction (T048)
MSH D003865
ICD10 F32.9
SnomedCT 370143000, 35489007
English Disorder, Major Depressive, Disorders, Major Depressive, Major Depressive Disorders, MDD, MAJOR DEPRESSIVE DISORDER, DEPRESSIVE DIS MAJOR, MAJOR DEPRESSIVE DIS, Major depressive disorder NOS, Major depressive illness, Major depression NOS, Depressive Disorder, Major [Disease/Finding], major depressive illness, major depressive disorder, major depression, Major depressive disorder (diagnosis), Major depression, Major depressive disorder (disorder), Major depressive disorder, Major depression, NOS, Major depressive disorder, NOS, Depressive Disorder, Major, Depressive Disorders, Major, Major Depressive Disorder, Major Depression
Dutch depressieve ziekte, depressieve stoornis NAO, major depression, Depressieve stoornis, ernstige, Ernstige depressieve stoornis, Involutiepsychose, Melancholie, involutionele, Parafrenie, involutionele, Psychose, involutionele, Involutiedepressie, Involutionele depressie
French Syndrome dépressif majeur SAI, Épisode dépressif majeur, Dépression grave, Grave dépression, Dépression majeure, Trouble dépressif majeur
German Major Depression NNB, schwere depressive Krankheit, Endogene Depression, Involutionsdepression, Melancholie, Involutions-, Paraphrenie, Involutions-, Psychose, Involutions-, Depressive Störung, majore, Majore depressive Störung
Italian Depressione maggiore NAS, Malattia depressiva maggiore, Depressione maggiore, Disturbo depressivo maggiore
Portuguese Doença depressiva major, Perturbação depressiva major NE, Depressão grave, Transtorno Depressivo Maior
Spanish Trastorno depresivo mayor NEOM, Enfermedad depresiva mayor, depresión mayor, trastorno depresivo mayor (trastorno), trastorno depresivo mayor, Depresión mayor, Trastorno Depresivo Mayor
Japanese 大うつ病NOS, オオウツビョウ, ダイウツビョウ, ダイウツビョウNOS, うつ病-退行期, 大うつ病性障害, 大鬱病, うつ病-更年期, 大うつ病, 初老期うつ病, 更年期うつ病, 更年期鬱病, 精神病-更年期, 退行期うつ病, 退行期パラフレニー, 退行期メランコリア, 退行期精神病, 鬱病-更年期, パラフレニー-退行期, 更年期うつ状態, 更年期メランコリー, 更年期精神病, 更年期鬱状態, 精神病-退行期, 退行期鬱病
Swedish Involutionsdepression
Czech psychóza involuční, deprese involuční, depresivní porucha unipolární, melancholie involuční, parafrenie involuční, Velké depresivní onemocnění, Velká deprese, Velká depresivní porucha NOS
Finnish Laaja-alainen masentuneisuushäiriö
Polish Wielkie zaburzenie depresyjne, Zaburzenie depresyjne wielkie, Ciężkie zaburzenie depresyjne, Depresja wielka, Parafrenia inwolucyjna, Depresja głęboka, Epizod depresji dużej, Depresja inwolucyjna
Hungarian Major depressiós betegség, Major depressio, Major depressiós zavar k.m.n.
Norwegian Depresjon, alvorlig, Markert depresjon, Depresjon, markert, Alvorlig depresjon, Markant depressiv forstyrrelse
Derived from the NIH UMLS (Unified Medical Language System)

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