Depression Flashcards
1
Q
Requirements for diagnosis to be depression
A
- Present for at least 2 weeks
- Not secondary to effects of drugs/alcohol, medication, medical disorder or bereavement
- May cause significant distress of impairment of social, occupational or general functioning
2
Q
Core symptoms
A
- Depressed mood
- Anhedonia (reduced interest)
- Weight change
- Disturbed sleep
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Reduced libido
- Feelings of worthlessness or inappropriate guilt
- Low concentration/indecisiveness
- Recurrent thoughts of death/suicide
3
Q
Somatic symptoms
A
- Loss of emotional reactivity
- Diurenal mood variation
- Anhedonia
- Early morning wakening
- Psychomotor retardation or agitation
- Loss of appetite and weight
- Loss of libido
4
Q
Psychotic symptoms/features
A
- Delusions
- Hallucinations
- Catatonic symptoms or marked psychomotor retardation (depressive stupor)
5
Q
Delusions in depression
A
- Poverty
- Personal inadequacy
- Guilt over presumed misdeeds
- Responsibility for world events
- Deserving of punishment
- Other nihilistic delusions
6
Q
Hallucinations in depression
A
- Auditory
- Defamatory or accustory voices, cries for help or screaming
- Olfactory
- Bad smells such as rotting food, faeces, decomposing flesh
- Visula
- Tormentors, demons, the Devil, dead bodies, scenes of death or torture
Mood incongruent delusions/hallucinations are also possible
7
Q
Diagnostic criteria/classification
A
- Mild
- 2 typical and 2 other core symptoms
- Moderate
- 2 typical and 3 other core symptoms
- Severe
- 3 typical and 4 other core symptoms
Can be with or without psychotic features
8
Q
Core symptoms
A
- 3 core symptoms
- Depressed mood
- Anhedonia
- Fatigue
9
Q
Epidemiology - prevalence
A
Around 5%
10
Q
Epidemiology - sex ratio
A
M:F 1:2
11
Q
Risk factors
A
- Genetics
- Childhood experiences
- Loss of parent, lack of parental care, parental alcholism, sexual abuse
- Personality
- Anxiety, impulsivity, obsessionality
- Social
- Divorced
- Lack of employment
- Adverse life events
- Loss
12
Q
Aetiology
A
- Not well known but biopsychomodel exists (attach image from page 245)
- Early adverse experience
- Personality factors
- Psychological factors
- Gender
- Social factors
- Brain pathology
- Neurotransmitter abnormalities
- Thyroid abnormalities
- Changes in sleep pattern
13
Q
Aetiology - early adverse experience
A
Foetal environment and later social environment has effect on HPA axis
14
Q
Aetiology - personality factors
A
- Mediates level of response to sensory experience which can increase vulnerability due to
- Autonomic hyperarousal
- Lability (unpredictable responses to emotional stimuli)
- Negative basis in attention, processing and memory for emotional material
15
Q
Aetiology - psychological factors
A
- Disruption of normal social, martial, parental or familial relationship correlated with high rates depression
- Adverse childhood events may increase susceptability to high response to later stressful events
- Low-self esteem vulnerability factor
16
Q
Aetiology - social factors
A
- Low income greater risk
- Social causation (stress associated with problems leads to depression)
- Social selection (predisposed people fall down social ladders or fail to rise them)
17
Q
Aetiology - brain pathology
A
- Ventricular enlargement and sulcal prominence
- Increased white matter lesions
- Hypoperfusion in frontal, temporal and parietal areas, and hyperperfusion in frontal and cingulate cortex
