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.
Criteria for PDD?
A. Depressed mood for most of the day, for more days than not, for at least 2 years
B. Presence, while depressed, of 2+ of following
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
C. During the 2 year period, never been w/o A or B for more than 2 months
Lifetime prevalence of PDD?
6% (with or without MDD)
Onset of PDD? And implications?
- Early and insidious (childhood, adolescent, or early adulthood)
- Early onset predictor of comorbid PDs and substance abuse disorders
- If PDD onset precedes MDD, greater likelihood of more frequent subsequent episodes
- 79% of people with PDD also experience MDE at some point
