Depression & Grief Flashcards
What is DSM?
The Diagnostic and Statistical Manual. This is used to standardize and improve reliability of diagnosis in psychiatry.
True or False: Depression can be momentary sadness
False. Depression is held to be not-momentary, but a brain disease, consisting of a constellation of symptoms.
What are the 2 cardinal symptoms of depression?
- Loss of interest or pleasure (anhedonia) from important activities
- Depressed mood, most of the day, nearly every day.
You need to have at least one of these to be diagnosed with depression.
What are the 9 symptoms of depression? (in addition to the 2 cardinal symptoms)
SIGECAPS
Sleep - too much or too little
Interests - loss of interest in activities they used to be interested in
Guilt - increased feelings of worthlessness
Energy - decreased
Concentration - decreased
Appetite - decreased or increased
Psychomotor agitation/retardation
Suicidal ideation, thoughts about death or suicide
How many criteria do you need to meet to be “depressed”?
At least 5/9 of SIGECAPS symptoms for at least 2 weeks in duration AND at least 1/2 of the cardinal symptoms. Also, you must have impairment in function socially, occupationally, or other important areas.
True or False: Depression is common
True (1/5 individuals lifetime prevalence)
True or False: Depressing is a leading cause of disability worldwide
True. Leads to poor self care, poor medical outcomes, potentially fatal.
True or False: Depression is very costly to individuals as well as society.
True
How many depressed people are diagnosed and treated?
It’s thought that only 50% of depressed are diagnosed and only 25% are treated adequately.
What’s the connection between depression and CVPR?
Increased CAD, stroke, MI. Worse outcomes. Doubling risk of cardiac events in the 1-2 years following MI
What are possible mechanisms for the connection between depression and CVD?
Physical inactivity Smoking Medication non-adherence Poor diet Lower heart rate variability Inflammatory processes
Where does depression screening start?
PHQ-2. If test is positive, do PHQ-9
2 is for the 2 cardinal symptoms
9 is for the 9 other symptoms
What’s the difference between a major depressive episode and a major depressive disorder?
Episodes are followed by recover/remission.
Episodes can be part of bipolar disorder where you have depression episodes followed by recover/remission and episodes of mania.
What are symptoms of mania/hyopmania? how many do you need for diagnosis?
DIGFAST (irritable/expansive mood with at least 3/7 of these symptoms. Also, the symptoms should be an unequivocal change from functioning baseline, able to be observed by others, and not due to the effects of drugs)
Distractibility
Irritable
Grandiosity, inflated self esteem
Flight of ideas, subjective experience of racing thoughts
Activities with high potential for painful consequences, goal directed
Sleep - decreased need for sleep
Talkativeness - pressured speech
What is Bipolar I?
Patients who have had mania but also may have had hypomania and major depressive episodes
