Depression Epidemiology and Biological Basis Flashcards
what are the core features of depression?
- low mood
- loss of interest and enjoyment (anhedonia)
- reduced energy
what is anhedonia?
loss of interest and enjoyment
what are the associated features of depression?
biological and cognitive
biological symptoms of depression?
- poor sleep
- loss of appetite
- loss of libido
- reduced concentration and attention
- fluctuating mood
- easily agitated
cognitive symptoms of depression?
- low self esteem/ reduced concentration
- guilt and worthlessness
- hopeless
- helplessness
- ideas of self harm/suicide
what are the key symptoms in diagnosis of depression?
- persistent sadness/low mood
- marked loss of interest or pleasure
what are the associated symptoms of depression?
- disturbed sleep
- decreased/increased appetite
- poor concentration
- feeling worthless/guilt
- suicidal thoughts and intentions
how are the key symptoms involved in diagnosis of depression?
at least one must be present most days most of the time for at least two weeks
when would general advice and active monitoring be appropriate?
- 4 or less symptoms with not much disability
- intermittent symptoms, less than two weeks
- no past or family history of depression
- good social support
- no suicidal thoughts
when would active treatment in primary care be appropriate?
- 5+ symptoms with associated disability
- persistent symptoms
- past or family history of depression
- low social support
- occasional suicidal thoughts
when would referral to mental health professionals be appropriate?
- inadequate response to 2+ interventions
- recurrent episode within 1 year
- suggestive history of bipolar disorder
- patient or relative request referral
- more persistent suicidal thoughts
when would urgent referral to specialist mental health services be appropriate?
- actively suicidal ideas/plans
- severely agitated
- severe self-neglect
how many severities of depression are there?
mild, moderate, severse
what is mild depression?
- two core symptoms
- two associated symptoms
none of them are intense, might be distressed, some difficulty continuing with normal life and social activity
what is moderate depression?
- two core symptoms
- 3/4 associated symptoms
difficulty continuing with normal life and social/domestic activity
what is severe depression?
- three core symptoms
- 4 associated symptoms with severe intensity
cannot continue with normal social/domestic/work activities, includes psychotic depression
less obvious ways that depression can present?
- headaches
- chest pain
- low back pain
- atypical facial pain
- fatigue
- poor memory
- weight loss
what is most important cause of misdiagnosis of depression?
somatisation
why is depression more common in women? (1:2 ratio)
men more likely to find maladaptive coping mechanisms like alcohol
suicide deaths in 15-29 year olds?
2nd leading cause of death
which has higher lifetime prevalence: bipolar or unipolar disorder?
unipolar depressive disorder (4-30%)
bipolar = 0.3-1.5%
bipolar male:female?
equal
internalising risk factors
genetics low self-esteem history of depression early onset anxiety disorder neuroticism/perfectionism
externalising risk factors
substance misuse
conduct disorder
genetics
