depression (clinical)

Question 1

what neurotransmitters can depression be associated with

Answer 1

serotonin mainly

also dopamine and noradrenaline

Question 2

structural brain changes linked with depression

Answer 2

ventricular enlargement

raised sucal prominence

Question 3

can depression be inherited

Answer 3

major depression inheritability is 37%

Question 4

psychological risk factor for depression

Answer 4

adverse childhood experiences

Question 5

social factors linked to depression

Answer 5

events (job loss, divorce)
stress
social isolation
poor social environment/class

Question 6

how long must symptoms be present for before you can call it depression

Answer 6

2 weeks

no alcohol, drugs, medical disorders or bereavement

Question 7

what are the 3 core features of depression

Answer 7

AAD
anhedonia (loss of pleasure)
anergia (lack of energy)
depressed mood

Question 8

features of the ‘depressed mood’

Answer 8

abnormal for the individual
most of the day, almost every day
uninfluenced by circumstances

Question 9

what are the additional symptoms that could be present in

Answer 9

loss of confidence/elf-esteem
unreasonable feelings of self-reproach/guilt
recurrent thoughts of death/suicide/suicidal behaviour
diminished concentration (symptom or sign)
psychomotor retardation/agitation
sleep disturbance of any type
increase or decrease in appetite

Question 10

diagnostic criteria for mild depression

Answer 10

2/3 core symptoms

2-3 additional symptoms

Question 11

diagnostic criteria for moderate depression

Answer 11

2/3 core symptoms

up to 4 additional symptoms

Question 12

diagnostic criteria for severe depression

Answer 12

3/3 core symptoms

5+ additional symptoms

Question 13

what are the subtypes of depression

Answer 13

somatic syndrome
atypical
psychotic
cotard’s syndrome

Question 14

what is somatic syndrome

Answer 14

clinical manifestation of depressive symptoms

Question 15

Diagnostic criteria of somatic syndrome that must be present

Answer 15

4 should be present of:
anhedonia 
lack of emotional reactions
early morning wakening
depression worse in the morning 
psychomotor retardation/agitation
loss of appetite
weight loss
loss of libido

Question 16

key feature of atypical depression

Answer 16

mood reactivity - mood brightens in response to actual or potential positive events

Question 17

what are the additional features of atypical depression and how many should be present to diagnose

Answer 17

2 or more of:
significant weight gain/increase in appetite
hypersomnia
leaden paralysis (heavy limbs)
interpersonal rejection sensitivity resulting in social/occupational impairment

Question 18

how psychotic depression differs from other forms of psychosis

Answer 18

related to depressive themes

typically mood congruent or hypochondrical

Question 19

what is cotard’s syndrome and who gets it

Answer 19

elderly 
nihilistic delusions (sensation of being partially/completely dead)

Question 20

MSE appearance

Answer 20

reduced facial expression
furrowed brow
unkempt

Question 21

MSE behaviour

Answer 21

reduced eye contact
limited gesturing
rapport difficult to establish
often tearful

Question 22

MSE speech

Answer 22

slow
low pitch and volume
monotonous
increased latencies (end of question and start of answer)
limited content - short and brief answers

Question 23

MSE mood and affect

Answer 23

low for both
flat affect
limited reactivity

Question 24

MSE thought (form)

Answer 24

slow/absent

Question 25

MSE thought (content)

Answer 25

negative/suicidal
failure/guilt
burden 
low self esteem
paranoid

Question 26

MSE perception

Answer 26

2nd person auditory hallucinations

Question 27

MSE cognition

Answer 27

slow thinking

poor concentration/attention (leading to poor memory)

Question 28

MSE insight

Answer 28

usually preserved

can sometimes blame symptoms on personal weakness/actions

Question 29

common manifestation of depression in elderly

Answer 29

‘pseudo-dementia’

depression mimics dementia