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Dr. David T. Plante (Psychiatry): A 78-year-old man was admitted to the inpatient psychiatry service of this hospital because of anergia and anhedonia.
Thirty-three months before admission, the patient was told by his physician that he needed surgical repair of an enlarging abdominal aortic aneurysm. Within 2 days, he began to have a depressed mood, anhedonia, and fatigue, followed by anergia, anxiety, insomnia, decreased concentration, and poor appetite, and he lost 6.8 kg. He stopped working, exercising, and attending social events. He saw a psychiatrist, who began treatment with lorazepam (0.5 mg twice daily), followed by trials of fluoxetine (10
Differential Diagnosis
Discussion of Management
Depression and Cardiac Disease
Diagnosis and Management of Depression in Patients with Cardiac Disease
Identification of Depression
Management of Depression
Management of Treatment-Resistant Depression
Diagnosis
Source Information
From the Department of Psychiatry (J.C.H., L.T.P., C.A.W., A.A.N.), the Cardiology Division (J.L.J.), and the Neuroradiology Division (S.R.P.), Massachusetts General Hospital; and the Departments of Psychiatry (J.C.H., L.T.P., C.A.W., A.A.N.), Medicine (J.L.J.), and Radiology (S.R.P.), Harvard Medical School.
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