Behavioral science - depression Flashcards
What is needed for DSM5 diagnosis of Major Depressive Disorder?
1) 5 of 9 cardinal symptoms
2) 1 or more needs to be sadness or loss of interest/pleasure
3) persists for two weeks or longer
4) Significantly impacts social functioning
5) can’t be attributable to substances or other med condition
What does SIGECAPS stand for?
S - sleep disturbance I - Interest/pleasure loss G - guilt/worthlessness E - energy loss/fatigue C - concentration/attention disruption A - appetite change S - suicidal ideation
What are the 9 DSM-5 behavioral criteria for major depressive disorder?
i. Decreased mood throughout most of the day, nearly every day – either self reported (sad, empty, hopeless) or observed (e.g. tearful) (In children /adolescents can be irritable)
ii. Diminished interest or pleasure in all or most activities throughout day, most days –either self reported or observed
iii. Loss or gain of 5% body weight within one month without dieting, or decrease in appetite
(Children may not reach expected weight gain)
iv. Insomnia or hypersomnia
v. Psychomotor agitation or retardation
vi. Fatigue or loss of energy
vii. Feelings of worthlessness or excessive guilt
viii. Diminished ability to think or concentrate, indecisiveness
ix. Recurrent thoughts of death of suicidal ideation
5/9 needed for 2 weeks, distress + social disturbance, cant be attributable to something else, need i or ii to be included in 5/9
What is SWAG? What is it used for?
Suicidlal, Weight change (5%), Anhedonia, Guilt
Used to differentiate sadness from depression
What is atypical depression?
depression marked by weight gain and hypersomnia
what is pseudo demnentia?
cognitive symptoms in depressed elderly often misdiagnosed as “dementia”
What is characteristic pattern of diurnal variation in major depressive disorder?
worse in AM than PM
What are characteristic psychomotor symptoms in major depressive disorder?
body aches, headaches, aggitation or retardation, vegetative depression
What is SAD? What are the treatments?
full-spectrum light exposure, psychotherapy , antidepressants
Are depressive symptoms in SAD typical or atypical?
Atypical - weight gain, hypersomnia
What type of patients exhibit masked depression?
elderly patients, obsessivecompulsive/
narcisstic personalities
What would bring masked depression patient to primary care doc?
psycho motor or somatic symptoms instead of typical depressive symptoms (SIGECA_S)
How do masked depression patients usually present clinically?
vague physical ailments but unaware/in denial of their depression
– stoic with psychomotor complaints
What are 6 medical causes of depressive syndromes that would exclude patients from DSM-V diagnosis of major depressive disorder?
• Hypothyroidism • Cushing’s Syndrome • Anemia • Brain injury, stroke • Vitamin deficiency (B12, Folate, Vit D) • Obstructive sleep apnea…
• Hypothyroidism • Cushing’s Syndrome • Anemia • Brain injury, stroke • Vitamin deficiency (B12, Folate, Vit D) • Obstructive sleep apnea…
can cause ______ and should be included in differential Dx for _______
medically induced depressive syndromes that would exclude DSM-V diagnosis of major depressive disorder
What are 4 biological factors implicated in major depressive disorder?
– Monoamine Deficiency • ↓levels of Dopamine (DA), Serotonin (SR), Norepinephrine (NE) – Monoamine Receptor excess – Loss of neurotrophic factors – Genetics • Serotonin transporter gene
Do monoamine receptors increase or decrease in major depressive disorder?
increase