From the Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
N Engl J Med. 2019 Feb 7;380(6):559-568. doi: 10.1056/NEJMcp1712493.
A 45-year-old woman with hypothyroidism that has been treated with a stable dose of levothyroxine presents to her primary care provider with depressed mood, negative feelings about herself, poor sleep, low appetite, poor concentration, and lack of energy. These symptoms began several months ago during a conflict with her partner. Although she has been able to continue with work and life responsibilities, she feels sadness most days and occasionally thinks that she would be better off dead. How would you evaluate and treat this patient?
一位 45 岁的妇女患有甲状腺功能减退症，一直服用稳定剂量的左甲状腺素进行治疗。她因情绪低落、自我感觉不佳、睡眠不佳、食欲不振、注意力不集中和缺乏精力而就诊于初级保健医生。这些症状是几个月前在与伴侣发生冲突时开始出现的。尽管她能够继续工作和承担生活责任，但她大多数天都感到悲伤，偶尔会觉得自己死了会更好。你将如何评估和治疗这位患者？
