Depression (10 & 11) Flashcards
What are the DSM criteria for depression?
1- Depressed Mood
2- Diminished interest
3- Significant changes in weight
4- Insomnia or hypersomnia
5- Psychomotor agitation or retardation
6- Fatigue or loss of energy
7- Feelings or worthlessness or inappropriate guilt
8- Diminished ability to think or concentrate/ indecicive
9- Recurrent thoughts of death/ suicidal ideation
How many symptoms must be present and for how long, in order to Dx depression?
5 or more (out of the 9) symptoms
Present during the same 2-week period
T/F: at least one of the symptoms of depression is either depressed mood or loss of interest
True
What is used to determine if a person has “normal” sadness or is depressed?
Need to have at least 1 or the following:
1- suicidality
2- Weight loss
3- Anhedonia
4- Guilt
Define atypical depression:
More likely to have weight gain and hypersomnia
Can also lead to leaden paralysis, carb craving, rejection sensitivity
What is psuedodementia?
cognitive symptoms in depressed elderly that are often misdiagnosed as “dementia”
What is diurnal variation?
More depressed in AM and better in the PM
What are psychomotor symptoms?
Physical complaints such as body aches and headaches
What is seasonal affective disorder (SAD)?
Usually associated with the shorter days of winter
Usually associated with atypical symptoms
How is SAD treated?
Full spectrum light exposure
Psychotherapy
Antidepressants
Explain masked depression?
Depressed patients presenting with vague physical ailments but unaware/ in denial of their depression
seem stoic
What are some possible medical causes of depressive symptoms?
Hypothyroidism
Cushing’s Syndrome
Anemia
Brain injury/ strokes
Vitamin deficiency (B12, Folate, Vit D)
OSA
Name 4 biological factors that can may lead to depression?
1- Monoamine deficiency (decreased DA, SR, NE)
2- Monoamine Receptor Excess
3- Loss of neurotrophic factors and degeneration
4- Genetic variation in serotonin transporter gene
Explain the receptor excess theory?
Increase transmitter and decrease receptor can lead to reversal of symptoms
After 4 depressive episodes…how do low genetic risk brains compare to high genetic risk brains?
They look the same
What is the stress- cortisl depression theory?
Stress increases glucocorticoids which decreases neurotrophic factors that leads to atrophy/ death of neurons
What is seen in a depressed brain upon imaging?
Hypoactive DLPFC and a hyperactive amygdala
T/F: Men outnumber women with depression
False…but women might seek help more often that can lead to this statistic
What are the Front line agents for depression?
SSRI, SNRI, NDRI
What are some older pharmacological treatments for depression?
MAOI, Triycic antidepressants (TCA), Sedating antidepressants, and Augmenting strategies (Lithium, thyroid hormone, atypical antipsychotic)
What Rx are used last for depression?
MAOI and TCA
Name some faster acting treatments for depression?
IV psychostimulants (ketamine)
Electroconvulsive therapy (ECT)–> shock treatment
Name 4 neurostimulation techniques:
Vagus Nerve Stimulation (VNS)
Transcranial Magnetic Stimulation (TMS)
Deep Brain Stimulation (DBS)
Transcranial Direct Current Stimulation (TDCS)
What is the fastest/ most effective method to get undepressed?
ECT shock treatment
What are some psychological treatments for depression?
Talk therapy, Cognitive/ Behavioral Therapy
