Depression Flashcards
What is depression?
Persistent low mood/ loss of pleasure in most activities
What are the two core symptoms?
ask about in the last month
Feeling down/ depressed/ hopeless
Loss of interest/ pleasure in doing things
What 7 symptoms make up the additional symptoms of depression?
(ask about in the last 2 weeks)
Fatigue/ loss of energy Guilt Suicidal thoughts Inability to think/ concentrate Psychomotor agitation or retardation Insomnia/ hypersomnia Increased appetite/ weight loss
How might atypical depression present?
Reactive mood increased appetite, excessive sleep, sensitivity to rejection
Based on the 9 symptoms, how is depression diagnosed?
5 symptoms, with at least one being a core symptom
feeling down + lost of interest/ pleasure
What defines ‘sub-threshold depressive symptoms’?
Person has at >2 but <5 of the symptoms
What is dysthymia?
Persistent sub-threshold depression (lasting >2 years)
What questions would you ask in a suicide screen?
- do you ever feel like life is not worth living?
- Do you ever think about suicide?
- Ever made plans to end life?
- Do you have the means to do so?
- What prevents you from acting on this?
What is the PHQ-9?
Quesionnaire to asses depression
Max score is 27. 12 recommended to consider intervention
How can mild-moderate depression be managed?
CBT
What class of drug is first line for management of moderate-severe depression? Give 3 examples
SSRI
Citalopram
Fluoextine
Sertraline
How do SSRIs work?
Inhibit re-uptake of serotonin, increasing its availability for neurotransmission
How long can they take to work?
What can happen in this time?
Up to 3-4 weeks
Symptoms may initially get worse
Why shouldn’t they be stopped suddenly?
How should they be stopped?
Withdrawal symptoms
Should slowly lower dose over several weeks
What is the effect of SSRIs on sodium?
Can cause hyponatraemia
May present with confusion
