Depression Flashcards
What clusters of symptoms might be present in depression?
affective cluster
cognitive-behavioural cluster
neurovegetative cluster
What symptoms come under the affective cluster in depression?
depressed mood as reported by the individual or observed
markedly diminished interest or pleasure in activities, especially those normally found to be enjoyable to the individual
What symptoms come under the cognitive-behavioural cluster in depression?
reduced ability to concentrate, marked indecisiveness
beliefs of low self-worth or excessive guilt
hopelessness about the future
recurrent thoughts of death, recurrent suicidal ideation, or evidence of attempted suicide
What symptoms come under the neurovegetative cluster in depression?
significantly disrupted sleep
significant change in appetite or significant weight change
psychomotor agitation or retardation
reduced energy, fatigue or tiredness after minimal exertion
How might depressed mood present in young children?
somatic complaints - headaches, stomach pains
whining
increased separation anxiety
excessive crying
How might depressed mood present in adolescents?
pervasive irritability
hypersomnia
hyperphagia
How might depressed mood present in older adults?
memory difficulties
other cognitive symptoms
Name some organic causes of depression
hypothyroidism
increased cortisol and blunted response to CRH
use of alcohol or other psychoactive substances such as cannabis, opioids
Define treatment resistant depression
depression that has not responded to 2 antidepressants at therapeutic doses administered for more than 6 weeks
How should treatment resistant depression be approached?
review the diagnosis
rule out organic causes
combination of medications - combo of antidepressants, augmentation with lithium
combination of medication and psychological therapy
electroconvulsive therapy
How long do depressive episodes typically last?
3-6 months with treatment
most people recover within 12 months
