Chap. 7 - MDD demographics and assessment

Question 1

__% of (or __ million) adults have MDD at any given time

Answer 1

5%, or 10 million

Question 2

MDD is the # __ cause of disability in the US

Answer 2

1

Question 3

The most common psych do seen in primary care is…

Answer 3

MDD

Question 4

Average age of onset of MDD

Answer 4

Mid - 20’s

Question 5

Gender distribution of risk of MDD:
Pre-pubertal
Reproductive years
Over 50

Answer 5

Pre-pubertal = equal risk
Reproductive years = women 25% vs men 12% risk
Over 50 = equal risk

Question 6

__% of those with MDD will commit suicide

Answer 6

15%

Question 7

People with MDD have __x greater risk of premature death

Answer 7

4 times

Question 8

After one year of treatment, __% will continue to meet full criteria, __% will meet partial criteria, and __% will be asymptomatic

Answer 8

40
20
40

Question 9

Prior episodes are or are not predictive of future episodes?

Answer 9

They are

Question 10

Top five risk factors for MDD

Answer 10

Family history
Prior episode
Female
Post-partum
Medical comorbidity

Question 11

Initial presentation is often _____ _____ complaints like _____ and _____, or _____.

Answer 11

Vague somatic complaints

Aches and pains, or lethargy

Question 12

SIGEMCAPS

Answer 12

Sleep disturbance
Interests decrease
Guilt
Endergy deficit
Mood changes (remember irritability)
Concentration impaired
Appetite changes
Psychomotor agitation or blunting
Suicidality

Question 13

MDD dx must include _____ or _____ _____.

Answer 13

Anhedonia

Depressed mood

Question 14

Overdosing on toxic agents like ASA or sleeping pills is considered to be of high, moderate, or low lethality?

Answer 14

Moderate

Question 15

Four labs to order when suspicious of MDD:

Answer 15

CBC
CMP
B12
Thyroid function tests

Question 16

MDD is a greater source of _____ for women than any other illness.

Answer 16

Morbidity

Question 17

Untreated MDD typically lasts _____ months or longer

Answer 17

Four

Question 18

Endocrine differentials for MDD

Answer 18

Hypothyroid
DM
Hyperaldosteronism

Question 19

Neuro differentials for MDD

Answer 19

Stroke
Dementia
Sleep apnea
TBI 
Parkinson's

Question 20

Infectious differentials for MDD

Answer 20

AIDS

Lupus

Question 21

Other differentials

Answer 21

Fibromyalgia/chronic fatigue syndrome

Electrolyte imbalance

Question 22

Top priority of MDD treatment

Answer 22

Safety

Question 23

Top two rule-outs for MDD (and for any disorder, really)

Answer 23

Medical conditions

Substance induced

Question 24

SSRIs - 6 of them

Answer 24

Celexa
Lexapro
Prozac
Paxil
Luvox
Zoloft

Question 25

SSRIs - two common SEs

Answer 25

GI upset

Sexual dysfunction

Question 26

TCAs - 2 common suffixes for this class

Answer 26

-ipramine
-triptyline
(and Doxepin)

Question 27

TCAs - most common SE profile

Answer 27

Anticholinergic (can’t see, can’t pee, can’t spit, can’t shit)

Question 28

When eating foods containing _____ and taking MAOIs, you are at risk for irreversible _____ _____.

Answer 28

Tyramine

Hypertensive crisis

Question 29

Combining MAOIs with the drug classes of ____, ____, and ____ puts you at risk for irreversible _____ _____.

Answer 29

SSRIs, TCAs, and Antipsychotics

Risk for hypertensive crisis

Question 30

Three common MAOIs are:

Answer 30

Nardil
Parnate
Selegiline

Question 31

Foods that contain tyramine include

Answer 31

Pork, alcohol, chocolate, cheese, and anything smoked or fermented.

Question 32

SNRIs - Name three

Answer 32

Effexor (venlafaxine)
Pristiq (desvenlafaxine)
Cymbalta (duloxetine)

Question 33

NDRI - Name one

Answer 33

Wellbutrin (bupropion)

Question 34

1 non-pharm, non-therapy treatment for MDD

Answer 34

ECT

Question 35

Other non-pharm, non-therapy treatments for MDD

Answer 35

Transcranial Magnetic Stimulation (TMS)
Vagal Nerve Stimulation (VNS)
Phototherapy

Question 36

Therapies for MDD

Answer 36

CBT

SFT (or, brief therapy)

Question 37

A single white male over 45 who recently lost his dog and drinks every night is about the highest possible risk for…

Answer 37

Suicide

Question 38

The elderly require what kind of assessment?

Answer 38

A functional assessment

Question 39

Three components of a functional assessment

Answer 39

ADLs (eating, bathing, toileting)
IADLs (shopping, cooking, driving)
Executive functioning (balancing the checkbook, keeping appointments)

Question 40

The drug class of ____ + the drug class of ____ = serotonin syndrome

Answer 40

MAOIs + SSRIs