Depression Flashcards
What is depression?
A medical condition that describes a spectrum of symptoms and signs relating to low mood that persist over a period of >2 weeks
Depression can range from normal experience to severe, life-threatening illness.
What is the typical duration of a depressive episode?
4-6 months
List key symptoms of depression.
- Anhedonia; low mood
- Reduced interest/pleasure
- Reduced energy or fatigue
What are associated cognitive symptoms of depression?
- Recurrent thoughts of death, suicidal ideation
- Low self-worth or excessive guilt
- Future hopelessness
What are associated biological symptoms of depression?
- Disrupted sleep
- Reduced concentration and attention
- Significant changes in appetite or weight
- Psychomotor agitation or retardation
What additional criteria must be met for a depression diagnosis?
- Significant functional impairment
- Not attributable to psychoactive substance use or organic mental disorder
- No hypomanic or manic episodes
What characterizes mild depression according to ICD-11?
- Four symptoms
- Distressed by symptoms to a mild extent
- Difficulty functioning in one or more domains
- No delusions or hallucinations
What defines moderate depression according to ICD-11?
- Five to six symptoms
- Few depressive symptoms present to a marked degree
- Considerable difficulty functioning in multiple domains
- Without psychosis
What are the features of severe depression according to ICD-11?
- Seven or more symptoms
- Many depressive symptoms present to a marked degree
- Serious difficulty functioning in most domains
- With/Without psychosis
What is postnatal depression?
An affective disorder affecting 10-15% of women presenting with depressive symptoms, often starting within a month or two after giving birth.
Name three differential diagnoses of depression.
- Seasonal Affective Disorder (SAD)
- Dysthymia
- Bipolar disorder
What is the epidemiological ratio of depression in females to males?
2:1
List five risk factors for depression.
- Previous depression
- History of substance misuse
- Family history of depression or suicide
- Domestic violence
- Recent stressful life event
What are some causative physical illnesses of depression?
- Cerebral tumour
- Stroke
- Parkinson’s
- Hypothyroidism
- Neurodegenerative conditions
What medications can cause depression?
- Corticosteroids
- Beta-blockers
- Antidepressants
- Alcohol
- Recreational drugs
What investigations are used for diagnosing depression?
- Social: collateral history and old notes
- Medical: urine drug screen, glucose, thyroid function tests
What are some measurement tools or scores to assess depression?
- Structured Clinical Interview for DSM Disorders (SCID)
- Hamilton Depression Rating Scale (HDRS)
- Patient Health Questionnaire 9 (PHQ-9)
What does a PHQ-9 score of 0-5 indicate?
Mild depression
What are the first steps in the management of depression?
- Recognition and Advice
- Active Monitoring and Low-Intensity Psychosocial Interventions
What is the recommended treatment for moderate-severe depression?
- SSRI OR Therapy OR Combined treatment
What should be done for non-responders after 3 to 4 weeks of treatment?
- Increase level of support and dose OR switch to another antidepressant
What pharmacological agents are commonly used for depression?
- SSRIs
- SNRIs
- TCAs
- MAOIs
What are some psychological therapies for depression?
- Cognitive Behavioural Therapy (CBT)
- Interpersonal Therapy (IPT)
- Individual Dynamic Psychotherapy (IDP)
What is Electroconvulsive Therapy (ECT)?
A treatment that uses electric current to induce a seizure for therapeutic results.
What is the follow-up protocol for patients starting antidepressants?
- 2 weeks after starting, then intervals of every 2 to 4 weeks for 3 months
