3. Depressive Disorders Flashcards
What has changed in the diagnosis for the DSM-V?
- previously there were 5 Axes that were used to diagnose a patient: Axis 2 was considered for mental retardation, Axis 4 involved biopsychosocial approach, axis 5 required comprehensive interview of determining functioning
- axes no longer exist
What is the serotonergic pathway?
- serotonin pathway identifies projection from neurons that synthesize and communicate serotonin
- emphasis on Raphe Nucleus projecting to the frontal cortex
What is the norepinephrine pathway?
- norepinephrine pathway is involved with alertness, arousal, and the rewards system
- places an emphasis on the locus coeruleus which acts on adrenergic receptors in the amygdala, cingulate gyrus, cingulum, hippocampus, hypothalamus
What is Disruptive Mood Dysregulation Disorder (DMDD)
- Occurs in children, only diagnosed ages 6-18
- consists of outbursts that are inconsistent with their developmental level
- defined by consistent irritability and anger between outbursts, does not go through waves
- must be present for 12+ months
- outbursts and mood must occur between home, school and peers
What is Major Depressive Disorder
- must meet 5 of 9 symptoms; symptoms must be present during a 2 week period
- 1 of these symptoms must be depressed mood or loss of interest/pleasure
- daily occurence of symptoms
What is the criteria for diagnosis of MDD?
- depressed mood most of the day
- diminished pleasure or interest or pleasure in all or almost all activities
- significant weight loss/gain
- insomnia or hypersomnia
- psychomotor agitation or retardation
- feeling of worthlessness or excessive/inappropriate guilt
- fatigue/loss of energy
- diminished ability to think or concentrate; indecisiveness
- recurrent thoughts of death, suicidal ideation or self-harm
Do low income countries have low rates of depressive disorders?
No, their rates of depressive disorders are higher but they are harder to study because there is no means for htem to get diagnosed
Which high income countries have the highest lifetime prevalence of depression and the highest 12 month/lifetime prevalence of depression?
- highest lifetime prevalence: France
- highest 12 month/lifetime: Israel
Which low-income countries have the highest lifetime prevalence of depression and the highest 12 month/lifetime prevalence of depression?
- highest lifetime prevalence: Brazil
- highest 12 month/lifetime: Ukraine
What is Persistent Depressive Disorder (Dysthymia)?
- characterized by depressed mood for most of the day that persists for at least 2 years.
- must be continuous
What is the criteria for diagnosis of Dysthymia?
- presence of two or more of the following:
1. poor appetite/overeating
2. insomnia/hypersomnia
3. low energy/fatigue
4. low self-esteem
5. poor concentration/difficulty making decisions
6. feeling of hopelessness
What are the major distinctions between Dysthymia and MDD?
Dysthymia has the following:
- it is always there, does not go away like a major depressive episode would
- brought on for no reason
- there are no suicidal ideations, moreso a lingering feeling of hopelessness/depression
What is double depression?
A period of major depressive episode where when you come down from it it is not at neutral, you are still at low functioning
What is Premenstrual Dysmorphic Disorder (PMDD)?
-PMS coupled with intense mood/anxiety changes right before your menstrual cycle
What is the timeline of onset of PMDD that allows you to distinguish it from PMS?
-PMDD occurs in the final week before onset of your menstrual cycle, symptoms start to improve within a few days of menstrual cycle and become minimal or absent in the week post-menstrual cycle
