Depression Flashcards
Define mood.
the sustained emotion experience reported by your patient.
Define affect.
The emotional tone we observe. For example a blunted affect,
constricted affect, flat affect, inappropriate affect or labile affect
When assessing mood and affect, what is an important assessment factor?
Are they congruent.
What do the terms “mood disorder” or “affective disorder” often refer to?
Illnesses such as depression and bipolar disorder.
What are the biological (biochemical) causes of depression?
- Imbalance, or inability to use, in neurotransmitters including serotonin, norepinephrine, glutamate, dopamine, acetylcholine, gamma-aminobutyric acid (GABA).
- Manifestations vary according to neurotransmitters but can impact cognition, mood, attention, impulse control, appetite, and sleep.
- Additionally, there may be a depletion of neurotransmitters associated with stress.
What are biological (genetic) causes of depression?
- Genetic factors play a role in depressive disorder development
- The concordance rate for MDD is nearly 50%. If one identical twin is affected, the second has about a 50% chance of being affected as well.
- Likely caused by multiple genes, each gene having a small but significant role in the development and severity.
What are biological (hormonal) causes of depression?
- Individuals with major depression have HIGH urine cortisol levels and corticotropin releasing hormone (CRH)
- Cortisol - plays a role in the fight or flight response
- Abnormal levels of hormones are caused by hyperactivity of the hypothalamic-pituitary adrenal axis** (exam)
**Estradiol affects receptors that are sensitive to serotonin, which is responsible for mood - Research is attempting to establish the relationship between sex hormones such as estrogen and testosterone to develop more effective therapies**
What are **biological (inflammation) **causes of depression?
- C reactive protein and interleukin 6
- elevation only seen in individuals who experienced a history of adversity
- young females with a hx of depression have elevated c-reactive protein and interleukin 6
- does not cause depression but research indicates it plays a role
- people who have inflammatory diseases have increased risk for depression
- Cytokine therapy, a cancer therapy, increases risk of developing MDD
What is the diathesis stress model of depression?
- Takes into account the interplay of biology and life events in the development of depressive disorders.
- The theory that mental and physical disorders develop from genetic and biological predisposition for that illness (diathesis) combined with stressful conditions that facilitate the development of that condition (stress)
Which populations have the highest prevalence of depression?
Highest prevalence among lower-income, unemployed and unmarried and divorced people.
What is the average age of onset for depression?
Average onset is between 15-45 years
True or false: depression is a normal part of aging
False: Common in older adults…but not normal part of aging
List the DSM depressive disorders.
1) Disruptive Mood Dysregulation Disorder
2) Major Depressive Disorder
3) Persistent Depressive Disorder (Dysthymia)
4) Premenstrual Dysphoric Disorder
5) Substance/Medication Induced Depressive Disorder
6) Depressive Disorder Due to Another Medical Condition
Depression and Grieving
What are the sub-types of major depressive disorder?
Psychotic features
- Melancholic features
- Atypical features
- Catatonic features
- Postpartum onset
- Seasonal features (SAD)
What does major depressive disorder look like clinically?
Depressed Mood, impaired functioning with:
- Emotional
- Cognitive
- Physical, and
- Behavioural symptoms
And experienced continually over 2 weeks
