Depression Flashcards
What are mood disorders?
Mood disorders are disorders of mental status and function where altered mood is a core feature.
How can mood disorders present?
Can present as a primary problem or as a consequence of other disorders or illnesses e.g. cancer, dementia, drug misuse or medical treatment
What is depression?
Depression as a symptom can be a state of feeling or mood that can range from a normal experience to a severe life threatening illness.
When is depression abnormal?
- Persistence of symptoms
- Pervasiveness of symptoms
- Degree of impairment
- Presence of specific symptoms or signs
What are the groups of symptoms for depression?
Psychological
Physical
Social
What are the psychological symptoms for depression?
Change in mood: Depression (diurnal function), Anxiety, Perplexity Anhedonia
Change in thought content: Guilt, Hopelessness, Worthlessness, Neurotic symptomatology (panics, hypochondrias), Ideas of reference (feeling that someone is laughing at you), Delusions and hallucinations
What is anhedonia?
No longer finding enjoyment in things that you once used to enjoy
What are the physical symptoms for depression?
Change in bodily function: Energy, Sleep, Appetite, Libido, Constipation, Pain
Change in psychomotor function: Agitation, Retardation (general slowing of thoughts, movements and speech)
What are the social symptoms for depression?
- Loss of interest (anhedonia)
- Irritability
- Apathy
- Withdrawal, loss of confidence, indecisive
- Loss of concentration, registration and memory
What is somatic syndrome?
- Marked anhedonia
- Apathy to distressing events
- Waking (2 hours before)
- Diurnal symptoms
- Objective evidence of psychomotor agitation or retardation*
- Marked loss of appetite*
- Weight loss*
- Marked loss of libido*
What is the ICD-10 definition of depression? i.e. the criteria for diagnosing depression
- At least 2 weeks
- No hypo/manic episodes
- Not attributable to psychoactive substance use or organic mental disorder
- If psychotic symptoms or stupor then severe depression with psychotic symptoms (differential schizophrenia)
What is the general criteria for depression? (3)
- Depressed mood for most of the day almost every day for the past two weeks, largely uninfluenced by circumstances
- Anhedonia
- Decreased energy, Increased fatiguability
What is the additional criteria for depression? (7)
- Loss of confidence
- Guilt or self-reproach or excessive guilt
- Concentration
- Agitation or retardation
- Sleep disturbance
- Change in appetite
- Recurrent thoughts of suicide or any suicidal behaviour
What is mild depression?
Two general criteria and a further two additional criteria. Total 4.
What is moderate depression?
Two general criteria and a further four additional criteria. Total 6.
What is severe depression?
All general criteria and a further five additional criteria. Total 8.
What do we know about post-natal depression?
- Risk of psychiatric admission 30 days following childbirth
- Most have ‘blues’ within 2 weeks (passes quite quickly)
- 10% of women developed major depressive disorder within 3-6 months
- Puerperal psychosis
What is cyclothymia?
Bipolar disorder but less severe
What is dysthymia?
Depression but less severe
What are the main classes of treatment for depression?
Antidepressants
Psychological treatment
Physical treatment
What is the first line drug for depression?
SSRI - Sertraline
What antidepressants are there for depression?
- SSRIs
- TCAs
- MAOIs
What psychological treatments are there for depression?
- CBT
- Interpersonal therapy (IPT)
- Individual dynamic psychotherapy
- Family therapy
What physical treatments are there for depression?
- ECT (severe depression)
- Psychosurgery
- Deep Brain Stimulation
- Vagal nerve stimulation
What measurement tools are used for depression?
SCID, SCAN, HDRS, PHQ-9
