Depression Flashcards
Define depression
Sense or lack of purpose or meaning
Differences between DSM-4 and DSM-5 for mood disorders
In DSM-5 the chapter ‘Depressive Disorders’ has been separated from the previous chapter ‘Bipolar and Related Disorders’.
The addition of Disruptive Mood Dysregulation Disorder (for children up to 12 years old) was added to replace Dysthymia in DSM-4.
Removed Grief exclusion from diagnosis of Major Depressive Disorders.
Added Disruptive Mood Dysregulation Disorder and Premenstrual Dysphoric Disorder.
DSM-5 MAJOR DEPRESSION criteria
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning.
- depressed mood most of the day, nearly every day
- markedly diminished or pleasure in all, or almost all, activities most of the day, nearly every day
- significant weight loss when not dieting or weight gain
- insomnia or hypersomina nearly every day
- psychomotor agitation or retardation nearly every day
- fatigue or loss of energy nearly every day
- feelings of worthlessness or excessive or inappropriate guilt nearly every day
- diminished ability to think or concentrate, nearly every day
- recurrent thoughts of death, recurrent suicidal ideation without a specific plan
Which 2 criteria under the major depressive episode is essential to have in order to be diagnosed with MAJOR DEPRESSION?
The first two criteria:
- depressed mood most of the day, nearly every day
- markedly diminished pleasure/interest in activities.
How likely are you to have another depressive episode after each depressive episode?
Chances increase by 16% after each depressive episode.
What is the lifetime prevalence of MAJOR DEPRESSIVE DISORDER?
16.4% lifetime prevalence
What is the one year prevalence in Australia?
3-5% one year prevalence in Australia
Gender prevalence for MAJOR DEPRESSIVE DISORDER
Twice as many women are diagnosed than men
2:1
How does MAJOR DEPRESSIVE DISORDER prevalence change throughout the years?
Children have about the same amount of boys and girls diagnosed, but during adolescence there is a massive increase in females diagnosed. But it then seems to even out after the age of 65.
Epidemiology in adolescence for MAJOR DEPRESSIVE DISORDER
15-30% in adolscence (14-18). Risk of depression rises greatly in adolescence.
How does MAJOR DEPRESSIVE differ from DSM-4 to DSM-5?
In DSM-4 there was a specification that symptoms are not better accounted for by bereavement - if you had recent bereavement than you had 2 months where you were able to feel like this without being diagnosed with Major Depression.
This has been removed in DSM-5. This sort of feelings can occur after the loss and the clinical person needs to use their own judgment whether this is a normal response or whether the person has a disorder.
Define PERSISTENT DEPRESSIVE DISORDER
Low level but long lasting depressive thoughts.
Depressed mood most of the day, more days than not.
DSM-5 PERSISTENT DEPRESSIVE DISORDER criteria
A. Depressed mood for most of the day, for more days than not, for at least 2 years.
B. Presence, while depressed, of two (or more) of the 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 of the disturbance, the individual has never been without symptoms in Criteria A and B for more than 2 months at a time,
How many months can someone diagnosised with PERSISTENT DEPRESSIVE DISORDER feel normal for?
No more than 2 months ‘normal’ mood in 2-years.
How long does it have to be until someone can be diagnosed with PERSISTENT DEPRESSIVE DISORDER?
Cannot be diagnosed unless it has been over 2 years.
