Depression

Question 1

What is the prevalence of depression?

Answer 1

5% chance of unipolar depression over lifetime
>1/38 adults at any one time
> more than 300 million at any one time

2/3 of those with MDD will also have an anxiety disorder at one point in their life

Twice as likely in women

Question 2

Diagnosis of major depressive disorder (MDD) according to DSM-5

Answer 2

Depressed mood most of the day
OR
Diminished interest/pleasure in everyday activities (anhedonia)

Plus 4 or more of the following symptoms

Question 3

The following symptoms in the DSM-5 diagnosis of MDD

Answer 3

Weight loss/gain
Insomnia/hypersomnia
Slowed thoughts and movement
Fatigue or loss of energy for the day
Feelings of worthlessness or excessive or inappropriate feelings of guilt
Diminished concentration or indecisiveness nearly everyday
Recurrent thoughts of death/suicide

Question 4

Clinically administered assessment scales

Answer 4

Hamilton depression scale (HDRS/HAM-D)

Montgomery-Asberg depression rating scale (MADRS)

Question 5

Self rating assessment scales

Answer 5

Beck depression inventory (BDI)

Question 6

Why are the depression rating scales useful?

Answer 6

Helps assess the severity of depression

Helps evaluate response to treatment

Promotes self management strategies

Question 7

What is sub-clinical depression?

Answer 7

Sadness plus 3 or more other symptoms for 10 days

There will be significant impairments in function even though clinical requirements are not met

Patients with MDD are more likely to experience sub-clinical depression between episodes of depression

Question 8

Dysthymic disorder diagnosis

Answer 8

Depressed mood for at least 2 years but not severe enough for a MD episode and 2 other symptoms.

95% of those with dysthymic disorder go on to develop MDD