A 59-year-old man with a history of major depressive disorder, asthma, and erectile dysfunction presents to his family physician complaining of depressed mood, amotivation, overeating, and anhedonia. He currently takes no medications. The patient has a 3 pack-year smoking history and would like to quit but has been unsuccessful in the past. His BMI is 29 kg/m^2. The physician suggests starting an antidepressant for the patient's mood symptoms. The patient is reluctant, as he used to take sertraline, but stopped it after his erectile dysfunction worsened. Which of the following antidepressants would be most appropriate for this patient?
ACitalopram
BBupropion
CSertraline
DMirtazapine
EAmitriptyline
A case-control study with a focus on risk factors that may influence the development of depression was conducted among the elderly population in one tertiary hospital in Malaysia. The study involved 150 elderly patients diagnosed with depressive illness from the psychiatry ward, as well as another group of 150 elderly patients without any history of depressive illness (but hospitalized for other reasons) at the same ward. The data were collected through questionnaires, and 2 principal investigators (who were also the patients’ attending physicians) acted as interviewers after proper training for the purposes of this study. Multivariate analyses of logistic regression with independent variables were employed to determine the adjusted odds ratio for the risk of developing depression. The study results showed that a lower level of social support, lack of education, and the presence of chronic illnesses highly correlated with depression. In order to maximally avoid bias that may stem from this kind of study design, what should the researchers have done differently to increase the validity of their results?
AUsed open-ended questions
BBlinded the investigators
CIncluded more interviewers
DUsed closed testing procedures on the data
EUsed Bonferroni correction on data
A 66-year-old man is brought into the emergency department by his daughter for a change in behavior. Yesterday the patient seemed more confused than usual and was asking the same questions repetitively. His symptoms have not improved over the past 24 hours, thus the decision to bring him in today. Last year, the patient was almost completely independent but he then suffered a "series of falls," after which his ability to care for himself declined. After this episode he was no longer able to cook for himself or pay his bills but otherwise had been fine up until this episode. The patient has a past medical history of myocardial infarction, hypertension, depression, diabetes mellitus type II, constipation, diverticulitis, and peripheral neuropathy. His current medications include metformin, insulin, lisinopril, hydrochlorothiazide, sodium docusate, atorvastatin, metoprolol, fluoxetine, and gabapentin. On exam you note a confused man who is poorly kept. He has bruises over his legs and his gait seems unstable. He is alert to person and place, and answers some questions inappropriately. The patient's pulse is 90/minute and his blood pressure is 170/100 mmHg. Which of the following is the most likely diagnosis?
ANormal aging
BLewy body dementia
CVascular dementia
DPseudodementia (depression-related cognitive impairment)
EAlzheimer's dementia
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