depression Flashcards
what is depression?
common mental health disorder typified by low mood, anhedonia, significant weight change, sleep and activity changes, fatigue, feelings of guilt or worthlessness, or poor concentration
how is it defined by ICD 11?
Depressive Episode: Depressed mood, loss of interest (anhedonia), and reduced energy (fatigue) persisting for at least two weeks.
how is it defined by DSM 5?
Major Depressive Disorder (MDD): Presence of a major depressive episode lasting at least two weeks, with specific criteria regarding mood, cognitive, and physical symptoms.
Persistent Depressive Disorder (Dysthymia): A chronic form of depression lasting for at least two years.
what’s mild depression?
Few, if any, symptoms in excess of those required to make the diagnosis (associated symptoms, see below), and the symptoms result in minor functional impairment.
what is moderate depression?
Symptoms or functional impairment between “mild” and “severe.”
what is severe depression?
The number of symptoms, intensity, and impairment are all greatly increased.
who is depression seen in?
higher in females
history of previous mental health issues, physical illnesses, and social challenges like divorce, poverty, and unemployment
features of depression?
presence of 5 out of the following 9 symptoms, occurring nearly every day for at least 2 weeks:
Depressed mood or irritability
anhedonia
5% weight change or change in appetite
sleep alterations
activity change
fatigue
guilt or feelings of worthlessness
cognitive issues
suicidality
features of severe depression?
what ix are done?
what questionnaires do you use?
There are several questionnaires that can also be used to help assess depressive symptoms, such as the Hospital Anxiety and Depression (HAD) Scale and Patient Health Questionnaire (PHQ-9).
what questions can you ask to screen for depression?
how does the HAD scale indicate depression?
how does the PHQ-9 scale indicate depression?
where is depression managed?
priamry care
how do you treat persistent subthreshold depressive symptoms or mild-to-moderate depression?
how do you treat mild depression unresponsive to treatment and moderate-to-severe depression?
how do you treat severe depression and poor oral intake/psychosis/stupor?
s/e of tx
how do you treat recurrent depression?
Treated with antidepressant + lithium
what is 1st line meds in depression?
SSRI eg sertraline
SNRIs eg venlafaxine can be used but less preferred
what are young people at risk of with antidepressants?
In people aged 18-25 there is an increased risk of impulsivity and suicidal risk upon commencing antidepressant medication and so they should have a follow-up appointment arranged after one week to monitor progress. Initial reviews can otherwise be arranged 2-4 weeks after starting medication in patients >25.
how should antidepraants be continued + stopped?
Continuation of antidepressants for at least six months post-remission is recommended to mitigate relapse risk. Tapering should be done gradually over a four-week period when discontinuing antidepressants.
