Depression Flashcards
symptoms:A SAD FACES
Appetite change (inc/dec)
Sleep changes (insomnia/hypersomnia)
*early morning awakening
Anhedonia- loss of interest in previously pleasurable activity including sex
Dysphoric mood with diurnal variation (pervasive/prolonged sadness)
Fatigue,unusual tiredness,lethargy,lack of motivation
Agitation(irritability),pschosocial retardation/social withdrawal
Concentration impaired
Esteem low (worthless), n other depressive thoughts (helpless.hopeless,guilt)
Suicidal thought/plan/attempts or death wish which are recurrent
duration
symptoms is present for most of the time and most days for at least two weeks
- can use 10-point Likert scale to score depression
*elicit core symptoms first
elicit dysphoric mood with diurnal variation
-how have u been feeling
- have u ever had a period of 2 week when your are unable to feel normal or happy,where u felt miserable and felt like crying?
-is the sadness cont
-is the sadness same throughout the day
*elicit core symptoms first
elicit Anhedonia
-what are your usual hobbies?
-have u ever had a period of 2 weeks or so when u lose interest in all your hobbies and pleasurable activities?
-what are your usual sexual pracices?
-was there a change in sexual activities when you lose interest in your hobbies?
elicit sleep changes
-during this period of sadness,how was your sleep?
elicit appetite changes
during this period of sadness,how was your appetite?explain
elicit fatigue/anergia
-during this period of sadness,how was your energy level?
- were u feeling unusually tired,like lying down most of the time and lack drive or motivation to do a task.explain.
agitation/psychosocial retardation/social withdrawal
-during this period of sadness,were u restless and irritable and tend to lose your temper often?
-were u disturbed by noise?
-did u avoid meeting others and prefer to be alone?
-is there slowing of your speech and movements.if yes,explain
elicit concentration impaired
-during this period of sadness,were u able to focus on a task?
-can u read/watch TV?
-were u having problems with memory
-if yes,explain
elicit esteem-low and other depressive thoughts
during this period of sadness,were u having thoughts that u were useless(worthless), a burden to others,disliked by all,no one can help u(helpless),that u have committed a sin (guilt) and there is no future for u (hopeless)
elicit suicidal thoughts/death wish
during this period of sadness,were u having recurrent thoughts that life is not worth living,it is better to be dead or wished to die?
if yes: have u tried to harm yourself (suicide attempt)
biological symptoms of depression
sleep changes
appetite changes
loss of libido,ED,frigidity
constipation
amenorrhea
anergia
comorbid psychiatric disorders
1)psychotic symptoms:
-Delusion of nihilism: do u believe that u have disappeared fr this world and no longer exist/body parts rotting away/world is coming to an end?
-Delusion of sin/guilt:do u believe that u are responsible for the suffering of others,that u have commited a sin and have to be punished
-Delusion of poverty: do u believe that all your wealth and property is lost
-hallucination:do u see things/hear voices that other people cant see or hear
2)manic symptoms of NMD mixed phase
3)anxiety disorder: when u were sad, did u also feel scared?
4) substance use disorder
what to elicit in past psychiatric history
-prev episodes of similar symptoms,single or recurrent?
-prev manic episodes?
-look for prev history of anxiety disorder
-look for past history of post partum disorder in female
diagnosis
-BMD stuff
- MDD w/x psychosis,single/recurrent episode
-MDD w/x psychosis,single/recurrent episode in remission
- mention any comorbidity
risk factors for suicide:SUICIDAL
Sex(male),single,separated/divorced/widowed,schizophrenia
Unemployment
Illicit drug use including alcohol,isolation( live alone)
Chronic medical condition with poor symptom ctrl
Inheritence (family history),intent to die
Depression
Attempted suicide,anxiety disorder,age( below 20,above 40)
Life events (chronic stress)
Premenstrual dysphoric disorder (late luteal phase dysphoric disorder)
PMS + significant func impairment and distress
depressive symptoms along with physical symptoms with symp remitting a few days of the onset of the menses
post partum blues
-transiet affective disturbance aft childbirth.
-lasts for few days
-spontaneous recovery
post partum depression
depressive symptoms emerging within 6 weeks aft childbirth.
if got psychotic symptoms= post partum psychosis
-risk of neglect of baby,bonding failur,suicide,infanticide
