Depression

Question 1

What is the diagnostic criteria for depression (the 9 signs)

Answer 1

Must show 5 of the 9 symptoms for SIG E CAPS
(Sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicide). One of the 5 must be depressed mood or anhedonia. Symptoms must last at least two weeks nearly every day and impair social/occupational functioning

Question 2

What is persistent depressive disorder?

Answer 2

A chronic, minor depression, also called dysthymia

Question 3

What is the typical onset for depression? How is this different than dysthymia?

Answer 3

Mid-thirties. Dysthymia usually presents earlier on in life.

Question 4

What is the lifetime prevalence of MDD for females? Males?

Answer 4

20% for females; 10% for males

Question 5

What % of people with MDD have major depression in relatives? What % with MDD have relatives with bipolar?

Answer 5

MDD relatives - 17%

BP relatives - 3%

Question 6

What is the concordance of MDD in monozygotic twins? Dizygotic?

Answer 6

Monozygotic = 30-50%
Dizygotic = 10-20%

Question 7

What is the approximate amount of time that someone with MDD spends in a depressive state?

Answer 7

One third of the patient’s life

Question 8

What percentage of patients will experience a manic episode later in life? What is a good predictor of whether or not that will occur?

Answer 8

Manic episode will occur in 25% of depression patients, especially if it is early onset.

Question 9

What do adolescents more commonly present with for MDD? What about elders?

Answer 9

Adolescents: Irritability rather than dysphoria
Elders: Anhedonia

Question 10

What does SIG E CAPS stand for?

Answer 10

sleep, interest, guilt, energy, concentration problems, appetite, psychomotor activity, suicidal thoughts

Question 11

What are 3 key screening questions for depression?

Answer 11

1. How would you describe your mood?
2. In the past month, have you felt down, depressed, or hopeless most of the day nearly every day?
3. Have you lost interest in or pleasure in doign things that you used to enjoy?

Question 12

What does the acronym DETRE stand for in the context of MDD treatment?

Answer 12

D = Consider other diagnoses
E = educate the patient about side effects, when the expect a respone
T = Treat with meds/psychotherapy etc
RE = re-evaluate in 1-2 weeks and check again at 2-4 weeks