1.1 What is depression? Flashcards
Waar gaat het artikel van WHO over?
WHO (2017)
- Wat depressie is
- De 2 categorieen van depressie
- General information
- Prevalence
- Suicide
Depressive disorders are defined by:
WHO (2017)
7
- Loss of interest
- Feeling low
- Insomnia/hypersomnia
- Increased/decreased appetite
- Lack of focus
- Feelings of worthlessness and guilt
- Lack of energy
–> Lead to impairments at school, work/daily life; long-lasting or repetitive; might lead to suicide
What are 2 main categories of depression?
WHO (2017)
- Major depressive disorder (MDD)
- Dysthemia
MDD
WHO (2017)
3 symptomen
- Diminished interest
- Low mood
- Reduced energy levels
Classified as mild, moderate or severe
Dysthemia
WHO (2017)
Chronic depression
Long lasting symptoms and mild version of depressive episode
Depression is one of the two main common mental disorders, which are:
WHO (2017)
- Depression
- Anxiety
How many people are impacted by depression?
WHO (2017)
More than 300 million (4.4% of world population)
Prevalence
WHO (2017)
4
- More in women
- Less in older age or for children under 15 years
- Prevalences have varying intensity levels
- Frequent in low and middle income countries
Suicide and depression
WHO (2017)
3
- Responsible for 1.5% of death around the world
- Very common in ages between 15-29
- Suicide frequently fluctuated depending on sex, region and income level.
Waar gaat artikel van Hermann over?
Hermann et al. 2022
- What is depression (symptoms and diagnosis)
- Complicated/uncomplicated depression
- Descriptors
- Characteristics
- Functioning affected by depression
- Depression literacy
- Conclusion
(Ook wel over culturele verschillen)
What is depression?
Hermann et al. 2022
Condition with clinically identifiable symptoms and observed behaviours related to distress and disturbance of personal functions (ICD-11)
Wat is verschil tussen ICD and DSM in depression?
Hermann et al. 2022
Symptom in ICD but not in DSM:
‘Hopelessness about the future’
=very strong indicator to differentiate people with and without depression.
Number of symptoms required for diagnosis
Hermann et al. 2022
5
This discriminates against cases that have less than 5 symptoms, but do have depression –> subthreshold depression.
Differentiate depression from regular sadness
Hermann et al. 2022
These could be used to address subthreshold depression:
1. Minimum 1 main depressive symptom: loss of pleasure or depressed mood, at least 2 weeks
2. Presence of any 2 depressive symptoms, for at least 2 weeks, with indication of social impairment
Patients Health Questionnaire (PHQ-9)
Hermann et al. 2022
Assesses severity of depression:
- commonly used
- Self-report
- Scored on 4-point likert scale
- Assesses 9 symptoms
Complicated vs uncomplicated depression
Hermann et al. 2022
This helps to determine the severity of depression.
Complicated= min 1 symptom of following:
- Suicidal ideation
- Feelings of wothlessness/guilt
- Psychotic symptoms
- Functional impairment
Descriptors
Hermann et al. 2022
Help diagnose depression instead of seperate diagnostic categories.
- Psychotic features
- Melancholia
- Atypical features
Characteristics depression
Hermann et al. 2022
- More common women
- Bias in ICD –> because majority of research is done in English speaking countries
- Comorbidity: substance, anxiety = common
- Physical comorbidity: diabetes, cognitive impairment, chronic pain, cardiovascular diabetes etc.
- Majority of suicidal death is due to depression
- Some have recurrent episodes, other have only one
Areas of functioning affected by depression
Hermann et al. 2022
5
- Early discontinuation of studies
- Decreased earning/income
- MDD males were more likely to get involved in intimate partner violence
- Depression in parents have adverse effect on children (anxiety, substance, physical health)
- Looking after people with depression is isolating –> bigger chance of depression yourselve
Protective factors
Hermann et al. 2022
- Social support
- Personality characteristics
- Interest
= resilience towards depression
Risk factors depression
Hermann et al. 2022
- Forced migration
Nog wel meer, maar deze staat nu als enige genoemd.
What leads to deficiency in seeking help, not following treatment regularly and suicidal ideation?
Hermann et al. 2022
Pessimistic views toward depression and discrimination
Depression literacy
Hermann et al. 2022
Comprehending strategies to achieve and maintain positive mental health, also understanding depression and its treatments.
- Might help to determine whether individual seek help or not
- Social interaction is very effective to improve depression literacy.
Conclusion Hermann
Hermann et al. 2022
- Many countries lack resources to deal with challenges of depression.
- There are not enough skilled providers and mental health care systems are not funded enough.
Waar gaat artikel Maj et al. over?
Maj et al. (2020)
- What is depression
- Verschil ICD en DSM
- 3 classes of depressive symptoms
- Subtypes depression
- Severity depression
- Personality traits
What are 9 symptoms for depression diagnosis (ICD and DSM)
Maj et al. (2020)
- Low mood
- Decreased interest/pleasure
- Lack of focus/indecisiveness
- Feelings of guilt/worthelessness
- Suicidal ideation
- Difference in appetite/weight
- Functional impairment
- Insomnia/hypersomnia
- Energy loss/tiredness
“Hopelessness about future” = ICD-11
What are extra indicators for depression?
Maj et al. (2020)
4
These are effective to distinguish between people with and without depression:
1. Irritability
2. Anxiety
3. Somatic symptoms (tension muscles, headaches)
4. Lack of reaction to positive stimuli
3 classes of depression
Maj et al. (2020)
Has no empirical support
- Cognitive Behavioural
- Neurophysiological
- Affective
Different symptoms according to sex: symptoms males:
Maj et al. (2020)
- More aggression
- Risk taking
- Irritability
2 main clinical subtypes of depression
Maj et al. (2020)
- Melancholic (autonomous)
- Non-melancholic (situational)
Melancholia
Maj et al. (2020)
Lack of pleasure and movement related activity.
Symptoms melancholia
Maj et al. (2020)
Sowieso 2 symptoms:
1. Lack of reaction to positive stimuli
2. Loss of pleasure in almost all activities
In combination with at least 3 of following:
1. Depression worse in morning
2. Low mood
3. Decreased movement related activity
4. Waking up very early in the morning
5. Excessive guilt
6. Significant weight loss/anorexia
Subtypes
Psychotic depression
Maj et al. (2020)
Hallucinations/delusions are present throughout depressive episode, psychotic not present outside depressive episode.
- In recurrent episodes: some episodes psychotic, some not. All episodes could be psychotic.
–> Also: increased risk suicide + increased risk biological causes
Subtypes
Mixed depression
Maj et al. (2020)
Min 3 manic symptoms should be present:
1. Elevated mood
2. Talking more
3. Increase self-esteem (grandiosity)
4. Increased energy
5. Racing thoughts
6. Not needing much sleep
7. Increased risk taking
(This type is not included in ICD-11)
Subtypes
Anxious depression
Maj et al. (2020)
Min 2 symptoms should be present:
1. Feeling strained (gespannen)
2. Anxious more than usual
3. Fear of somethin bad happening
4. Lack of focus due to worry
5. Feeling of losing control over self
–> Also: increased likelihood suicidal ideation, poor performance and poor life quality, more likely to be chronic.
Subtypes
Seasonal depression
Maj et al. (2020)
Depends on patterns of depressive episodes throughout one’s life.
During: spring/summer or autumn/winter
Symptoms:
1. Excessive eating
2. Craving carbohydrates
3. Hypersomnia
DSM classification of severity
Maj et al. (2020)
- Mild: not many more symptoms than necessary for diagnosis. Symptoms are manageable, functioning in social/work slightly negative.
- Moderate: is not defined, apart from the mention of its presence between mild and severe.
- Severe: more symptoms than necessary for diagnosis, unmanageable and affect social/work severely
ICD classification of severity
Maj et al. (2020)
- Mild: intense symptoms are absent, challenges in education/work/social/family/performance.
- Moderate: symptoms more intense than mild, more challenge in performance
- Severe: most symptoms present, some very intense, nearly completely unable to perform in different areas
Personality traits depression
Five Factor Model (FFM)
Maj et al. (2020)
- Extraversion/introversion
- Openness to experience/unconcentionality
- Agreeableness/antagonism
- Neuroticism
- Conscientiousness/disinhibition
Which of FFM makes people more prone to negativity/depression/anxiety?
Maj et al. (2020)
Neuroticism
Causes people ot interpret neutral situations negatively, react negatively to stress and be overwhelmed in reaction to small problems.
Cognitive triad
Maj et al. (2020)
People with depression have a negative view of the world, themselves and their future.
