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Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine

Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine. Depression. Depression. Descriptive epidemiology Life time prevalence: M=5-12%, F=10-25% Prevalence: M=4.7%, F=6% Incidence: 1.6% Sex: F=M*2, Stress, Hormones, Weakness

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Community Medicine V Dr. Mehrdad Askarian MD, MPH Professor of Community Medicine

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  1. Community Medicine VDr. Mehrdad Askarian MD, MPHProfessor of Community Medicine

  2. Depression

  3. Depression • Descriptive epidemiology • Life time prevalence: M=5-12%, F=10-25% • Prevalence: M=4.7%, F=6% • Incidence: 1.6% • Sex: F=M*2, Stress, Hormones, Weakness • Age: 50% of patients are 20-50 y/o. increasing in <20 y/o bcz of alcohol, stressors. • Groups: no definite difference

  4. Depression • Descriptive epidemiology • Religion: +ve effect • Environment: 20-30% of persons in hospitals have degrees of depression • Marital status: less in married • Family hx: +ve effect, alcoholism, suicidal attempts • Social & Cultural: more in immigrants, urban, young adults, low economics

  5. Depression • Descriptive epidemiology • Good prognostic factors: mild dx, no psychosis, short hospital admissions, good friendship, marriage, good social capacity during last 5 years, less than one hospitalization, older age of onset. • Poor prognosis: concordance with dysthymia, alcoholism, more than one admission hx, Male gender.

  6. Depression • Descriptive epidemiology • Risk factors: multifactor, Social, Spiritual, biologic, psychiatric,

  7. Depression • Descriptive epidemiology • Biological • Biogenic amines (NEP, Ser, Dop) • Endocrine – neurologic Axis: (Adrenal, thyroid, hormonal changes like prol, FSH…) • Circadian cycle disturbances & Sleep disorders • Immuno-neurogenic imbalance: (cortis-hypothal) • Neuroanatomic changes: smaller frontal lobe, lower blood supply • Genetics: strong

  8. Depression • Descriptive epidemiology • Biological • Biogenic amines (NEP, Ser, Dop) • Endocrine – neurologic Axis: (Adrenal, thyroid, hormonal changes like prol, FSH…) • Circadian cycle disturbances & Sleep disorders • Immuno-neurogenic imbalance: (cortis-hypothal) • Neuroanatomic changes: smaller frontal lobe, lower blood supply • Genetics: strong

  9. Depression • Descriptive epidemiology • Psychosocial Factors: • Environmental and life stress: (parent loss<11y/o, partner loss • Family: very important • Personalities: paranoids, antisocials, externalizing, projection protects • Psychoanalytic & psychodynamics: loss of love object • Educationalists: adaptation • Cognitive hypothesis: -ve judgement from himself then vicious cycle

  10. Depression • Descriptive epidemiology • Spritual: • Protects people

  11. Depression • Prevention • Primary: teaching different groups • Secondary: Screening & treatment • Tertiary: Spritual, Supportive, Family therapy

  12. Any Comments or Questions?

  13. DISCUSSION & QUESTIONS??

  14. Thank you for your kind attention

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