Depression Flashcards
Criteria for MDD?
A. Five or more symptoms (at least 1 essential criteria) within a two week period, a representing a change from previous functioning
At least one of
- Depressed mood most of the day, nearly every day (self report or observation by others)
- Markedly decreased interest or pleasure in all, or almost all activities
- Anhedonia
- Self report or observation by others
And at least three/four of
- Change in appetite nearly everyday, or significant weight loss/gain when not dieting (change of >5% of body weight in a month)
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day; has to be noticeable/observable
- Fatigue or loss of energy nearly every day, without physical exertion
- Feelings of worthlessness or excessive or inappropriate guilt
- Not just guilt about depression
- Suicidality
- Recurrent thoughts of death
- Recurrent suicidal ideation
- Specific plan for committing suicide
- Suicide attempt
B. Symptoms cause clinically significant distress or impairment
C. Not due to effects of substance, or another medical condition
‘Non-essential’ MDD criteria?
And at least three/four of
- Change in appetite nearly everyday, or significant weight loss/gain when not dieting (change of >5% of body weight in a month)
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day; has to be noticeable/observable
- Fatigue or loss of energy nearly every day, without physical exertion
- Feelings of worthlessness or excessive or inappropriate guilt
- Not just guilt about depression
- Suicidality
- Recurrent thoughts of death
- Recurrent suicidal ideation
- Specific plan for committing suicide
- Suicide attempt
Suicidality in increasing degrees of seriousness?
- Suicidality
- Recurrent thoughts of death
- Recurrent suicidal ideation
- Specific plan for committing suicide
- Suicide attempt
Associated features of MDD?
- Tearfulness
- Irritability
- Brooding
- Obsessive rumination
- Anxiety, phobias
- Excessive worry over physical health
- Complaints of physical pain
12 month prevalence of MDD?
7%
Which age group is MDD more prevalent in?
More prevalent in 18-29 y.o (3x higher) than in 60+ age group
Women ____ x higher prevalence than men
2
MDD - heritable?
Yes. MDD 1.5 - 3x more common amongst first-degree biological relatives
Average age of onset of MDD?
Average onset mid-20s, but is decreasing
Relationship between major life events and MDEs?
Major life events are strong predictor of initial depressive episodes, but relationship diminishes with subsequent episodes
Course of MDD?
Variable; some chronic, some experience remission
Average DE length?
6-9 months if not treated
MDD recovery?
- Typically begins within one year of onset
- Recency of onset a strong determinant of recovery
- Incomplete inter-episodic recovery a predictor of increased likelihood of subsequent episodes
- Remisson periods are longer early in the course of MDD
- Majority of cases experience remission
- 20-30% remain in ‘partial remission”; don’t meet full criteria for MDE
Does likelihood of having another episode increase with each episode?
Yes.
- Experiencing first - 55% of 2nd
- Experiencing second - 70% of 3rd
- Experiencing third - 90% of 4th
What is PDD?
Dysthymia. Less severe, but more chronic version of MDD.
