Depression

Question 1

core symptoms of depression

Answer 1

1. Depressed mood for most of the day, every day. Little variation in mood despite changes in time, circumstances or activity. May be diurnal variation (worse in mornings)
2. Anhedonia- loss of interest or pleasure in daily life- especially in things previously enjoyed
3. Decreased energy and increased fatiguability

Question 2

Additional symptoms of depression

Answer 2

poor appetite with weight loss
Disrupted sleep- initial insomnia or early wakening
agitation or retardation
decreased libido
reduced concentration
feelings of worthlessness and inappropriate guilt
recurrent thoughts of death, suicidal ideation

Question 3

Diagnosing depression

Answer 3

there must be two core symptoms and 2 or more typical symptoms- present every or nearly every day for at least 2 weeks

Question 4

mid depression

Answer 4

2 core symptoms, 2 typical symptoms

Question 5

moderate depression

Answer 5

at least 2 core symptoms, additional symptoms to give a total of 6

Question 6

severe depression

Answer 6

all 3 core symptoms, typical symptoms to give a total of 8

Question 7

somatic syndrome

Answer 7

4 of the following-
loss of interest/pleasure in pleasurable activites
lack of emotional reactions
waking 2hrs before normal time in morning
depression worse in morning
objective evidence of agitation
marked loss of appetite, weight loss
marked loss of libido

Question 8

Atypical depression

Answer 8

mood reactivity- bright mood in response to positive events
2 or more of
significant weight gain/ increase in appetite
hypersomnia
leaden paralysis
long standing pattern of interpersonal rejection sensitivity

Question 9

Psychotic depression

Answer 9

paranoid

Question 10

contards syndrome

Answer 10

more common in elderly

nihilistic delusions “can’t eat because bowels have turned to dust”

Question 11

Monoamine hypothesis

Answer 11

decreased monoamine function ge 5-HT, noradrenaline, dopamine

Question 12

Mild depression treatment

Answer 12

low intensity psychological interventions - self help books, computerised CBT- unless symptoms extend beyond 8 wks- then antidepressant medication should not routinely be used

Question 13

Moderate depression treatment

Answer 13

Combination of antidepressant and high intensity psychological intervention

Question 14

severe depression

Answer 14

high risk of suicide, rapid specialist mental health assessment with a consideration of inpatient admission

Question 15

non prescribed herbal remedy for depression

Answer 15

St Johns wort- affects drug metabolism including efficacy of the oral contraceptive pill