Depression Flashcards
What is the 12-month prevalence of major depression?
3.7%
What is the lifetime prevalence of major depression in international community studies?
6-25%
What is the lifetime prevalence of major depression (US)?
16.6%
What is the lifetime prevalence of dysthymia (US)?
2.5%
What four distinctions are made within depression in DSM-5 and ICD-10?
Major depression, bipolar disorder, dysthymia and cyclothymia
What is major depression characterized by?
Episodes of low mood, negative cognition, and sleep and appetite disturbance
What is bipolar disorder characterized by?
Episodes of low mood, negative cognition, and sleep and appetite disturbance plus episodes of mania in which elation, grandiosity, flight of ideas and expansive behavior occur.
What is dysthymia characterized by?
Depressive symptomatology (at least three symptoms in addition to low mood)
What is cyclothymia characterized by?
Similar but less extreme mood fluctuations than bipolar disorder
What does major depression and bipolar disorder have in common?
They are both episodic mood disorders
What does dysthymia and cyclothymia have in common?
They are both non-episodic chronic conditions of at least two years duration
What is the gender distribution of depression?
In children there is none but this changes in adolescence and by adulthood about twice as many women have depression as men
What is the comorbidity with anxiety disorders?
59%
What is the comorbidity with substance use disorders?
24%
What is the comorbidity of personality disorders in clinical samples?
50-85% of inpatient, 20-50% of outpatients
How many recover from depression?
About 90%
How many with a major depressive disorder commit suicide?
4-7%
How many who commit suicide have major depressive disorders?
23-52%
What medication is used against depression?
Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs) and novel or dual-action antidepressants
What is the diagnostic duration criteria for major depression in DSM-5?
Symptoms present nearly every day for at least two weeks
What is the diagnostic key symptoms of major depression in DSM-5?
Depressed mood, markedly diminished interests or pleasure, most of the day, nearly every day
What is the diagnostic ancillary symptoms of major depression in DSM-5?
Significant change in appetite or weight, insomnia or hypersomnia, psychomotor retardation or agitation nearly every day, fatigue or loss of energy nearly every day, feelings of worthlessness or excessive or inappropriate guilt nearly every day, diminished ability to think or poor concentrations nearly every day, recurrent thoughts of death, recurrent suicidal ideation without a specifik plan or a suicide attempt or a specific suicide plan
What is the diagnostic criteria for diagnosis and severity of major depression in DSM-5?
1 key symptom and at least 5 symptoms in total plus clinically significant distress or impairment in social occupational, educational functioning.
(Plus a distinction between mild, moderate or severe depression)
What is the diagnostic exclusions criteria of major depression in DSM-5?
No history of manic or hypomanic episode; not due to effects of a substance or a general medical condition; not better explained by another disorder (e.g. schizoaffective disorder)
What is the diagnostic recurrent depression criteria of major depression in DSM-5?
Two or more major depressive episodes with at least two months between episodes when criteria are not met for a major depressive disorder
What is the diagnostic criteria for major depression with melancholic features in DSM-5?
Either loss of pleasure in almost all activities or lack of reactivity to pleasurable stimuli during worst phase of episode and 3 or more of the following:
- Distinct quality of depressed mood
- Worse in the morning
- Early morning waking
- Marked psychomotor agitation or retardation
- Significant weight loss
- Excessive guilt
What is the diagnostic criteria for major depression with mood congruent psychotic features in DSM-5?
Delusions and hallucinations with theme of inadequacy, guilt, disease, death, nihilism, or deserved punishment
What is the diagnostic criteria for major depression with mood incongruent psychotic features in DSM-5?
Delusions and hallucinations without depressive theme
What is the diagnostic criteria for major depression with anxious distress in DSM-5?
2 of the following:
- Tense
- Restless
- Poor concentrations due to worry
- Fear something awful will happen
- Fear of loss of control
What is the diagnostic criteria for major depression with mixed features in DSM-5?
3 of the following which are not due effect of a drug and do not meet criteria for bipolar disorder:
- Elevated mood
- Grandiosity
- Pressure of speech
- Flight of ideas
- Increased energy
- Excessive risk taking
- Decreased need for sleep
What is the diagnostic criteria for major depression with atypical features in DSM-5?
During most days there is mood reactivity and 2 or more of the following:
- Increased appetite or weight gain
- Hypersomnia
- Leaden paralysis
- Chronic interpersonal rejection sensitivity
- Melancholic and catatonic features are absent
What is the diagnostic criteria for major depression with catatonia in DSM-5?
3 or more of the following:
- Stupor
- Cataplexy
- Waxy flexibility
- Mutism
- Negativism
- Posturing
- Mannerism
- Stereotypy
- Grimacing
- Echolalia
- Echopraxia
What is the diagnostic criteria for major depression with permpartum onset in DSM-5?
Onset during pregnancy or within a month of delivery
What is the diagnostic criteria for major depression with seasonal pattern in DSM-5?
Onset in fall and winter and remission in spring over a 2-year period
What is the diagnostic duration of a depressive episode in ICD-10?
Symptoms present nearly every day for at least 2 weeks
What is the diagnostic key symptoms of a depressive episode in ICD-10?
Depressed mood, loss of interest or pleasure in pleasurable activities, decrease energy or increased fatiguability
What is the diagnostic ancillary symptoms of a depressive episode in ICD-10?
change in appetite or weight (increase or decrease), disturbed sleep, psychomotor retardation or agitation, low self-esteem or confidence, self-reproach or guilt, reduced concentration and attention, ideas or acts of self-harm or suicide
What is the diagnostic criteria for diagnosis and severity of a depressive episode in ICD-10?
Mild depression:
- 2 key and 4 symptoms in total
Moderate:
- 2 key and 6 symptoms in total
Severe:
- 3 key and 8 symptoms in total
What is the diagnostic exclusions of a depressive episode in ICD-10?
No history of manic episodes, not due to substance abuse, an organic disorder or schizophrenia or schizoaffective disorder
What is the diagnostic criteria of a recurrent depressive episode in ICD-10?
At least one previous episode of 2 weeks duration
What is the diagnostic somatic syndrome of a depressive episode in ICD-10?
4 of the following must be present and this is commonly associated with severe depression:
- Loss of interest or pleasure in pleasurable activities
- Lack of emotional reactivity
- Waking in the morning 2 hours or more before the usual time
- Depression worse in the morning
- Psychomotor retardation or agitation
- Marked loss of appetite or weight (5% in a month)
- Marked loss of libido
What is the diagnostic psychotic symptoms of a depressive episode in ICD-10?
Any of the following must be present and this is usually associated with severe depression
- Delusions
- Hallucinations
- Depressive stupor
In what group is depression most likely to be diagnosed?
More common in adolescents than pre-adolescents
What comorbidity is there for depression in kids?
10-17% for behavioral disorders, anxiety disorders and attention disorders
In kids and adolescents how long does a episode of major depression last?
7-8 months
