Clinical depression commonly occurs concurrently with other medical illnesses and worsens the prognosis for these illnesses. Even diagnosis of concurrent illness is made much more difficult by the presence of depression. There are no inevitable physical findings of depression, though some manifestations may be seen quite often. These factors include a history of mental problems or substance abuse, suicide, family violence of any type, and separation or divorce. Typically, neurotransmitters are passed from neuron to neuron.
Depression is a clinical diagnosis.
Laboratory tests are primarily used to rule out other diagnoses. The emergency physician's responsibility in managing a patient with depression is to maintain a high index of suspicion for the diagnosis, especially in populations at risk for suicide. Although primary at-risk populations include young adults and elderly persons, depression and suicidality can occur in any age group, including children. In any such patient, screening for diagnostic symptoms of major depression and suicidality is mandatory. When a patient has contemplated or attempted suicide, the burden is on the physician to directly explore the situation with the patient in as much detail as possible to determine the current presence of suicidal ideation as well as accessible means and plans.