Depression Flashcards
Kids with DMDD are more likely to develop what?
MDD or anxiety
How long do DMDD sx need to be present for?
1 year
In DMDD, temper outbursts how many x/week?
3 or more
DMDD cannot co-exist with which three other d/o?
ODD, intermittent explosive, bipolar
DMDD can only be made between the ages of?
6-10
Does DMDD trump a bipolar dx?
No
Does DMDD trump an ODD dx?
Yes
Difference bw grief and MDD
Comes in waves
Predominant feelings of emptiness and loss
Rare to have guilt, worthlessness, SI or psychomotor
Self esteem is preserved
Onset within 2 mo of death and does not last more than 2 mo
Prevalence of depression at 12 months?
7%
When does depression peak?
In 20s and 40s
When does recovery being?
Within 3 months in 2/5 and 1 yr for 4/5
What is the gender difference in MDD epi?
Difference in prevalence (females are 3x higher) but not in response or course
T/F- suicide attempts decrease with age but completed suicides do not
True
There is memory loss for recent and remote events in
pseudodementia
In dementia the memory loss is just for recent
Recurrence of depression in 6m,2y,5y
25, 50, 75%
Post stroke depression most common on which hemisphere?
Left
Early onset PDD is before age
21
What is the time course of PMDD
sx present in the week before menses (luteal phase), improve with start of menses and absent in the week post menses
Criteria for PMDD
B) lability, irritability, depressed mood, anxiety
C) SIECA, overwhelmed, out of ctrl, physical sx (bloating)
Do sx of PMDD worsen as they approach menopause
Yes
Anxious distress specifier is
At least two of: keyed up, restless, decreased conc,fear that something awful may happen, fear of losing ctrl
Melancholic feature criteria include
A) Anhedonia!
B) Three or more: depression, worse in am, early morning awakening, agitation or retardation, weight loss, guilt
Melancholic depression predicts
psychosis
Atypical depression is also known as
Hysteroid dysphoria
Atypical depression criteria include
A) mood reactivity
B) Two or more: hypersomnolence, increased appetite, leaden paralysis, interpersonal issues
T/F- Atypical depression responds better to MAOIs than TCAs
T
What timespan includes peripartum dep onset
during pregnancy or 4 w post partum
In seasonal pattern do you need full remission in the “non-season”? T/F
False
Full remission OR a change i.e (dep to mania)
Seasonal pattern is most likely in which d/o
BPII
Can you have non seasonal depression and still meet criteria for SAD?
yes, as long as seasonal outnumbers non-seasonal in the individual’s lifetime
Describe the mood in between outbursts in DMDD
persistently irritable
How long does DMDD sx have to be present for?
1 yr
What age group can the DMDD dx NOT be made?
Less than 6 and after 18
What percentage of post partum depression depression starts during pregnancy?
50%
Other than depression what other d/o increases risk of post partum depression?
Anxiety, panic attacks
Risk of post partum psychosis is increased for which three groups of women?
- past post partum mood episodes 2. hx of mood episodes (particuarly BPI) 3. family hx of BP
What’s the risk of having another post partum psychosis if you’ve already had one?
30-50%
First line complementary tx for MDD
- Light 2. exercise 3. St. Johns
T/F CBT= light therapy in acute MDD
T
T/F CBT = light therapy in the long term for MDD
F- CBT is better 2 yrs later
AD should be switched if there is only minimal improvement after how long?
2-4 weeks
1st line augmenting meds (name 3)
abilify= quetiapine= risperidone
What % of PDD progress to bipolar and depression?
20% (5% I and 15%II) and 20%
Difference in length between baby blues and PP depression.
3-5 days versus 3-6 months
Atypical depression is a predictor of which other disorder
BPI
Atypical depression is co-morbid with which two other dx
- social phobia 2. avoidant PD
Most common cause of death in a depressed pt?
Cardiovascular disease
Which three meds have no RCT evidence for agumenting but are 3rd line?
- methylphenidate 2. AD (other than buproprion and mirt) 3. ziprasidone
In depression REM moves from which part of sleep?
Moves from later to earlier
AD do what to REM?
Suppress REM
In depression how does TSH respond to TRH?
Decreased response
Which one medication is not recommended as an adjunct in MDD
pindolol
Does rTMS cause seizures?
Can happen but it is not intended
What is the one absolute contraindication in rTMS?
metallic hardware in the head ,except the mouth
What two regions of the brain have decreased metabolic activity in seasonal patterned illness?
- orbital frontal cortex 2. left inferior parietal lobe
In mild depression with concurrent ADHD, which do you treat first?
ADHD
only if severe SI then tx MDD first
During which time period after admission is someone most likely to complete suicide
3 mo after d/c
for which gender does the risk of suicide decrease with age
females
what pattern does male suicide risk follow across the lifespan
two peaks
most common psyc manifestation of hyperparathyroidism
depression with anergia
