depression part 1 Flashcards
DSM-5 Major Depressive Disorder criteria :
sxs are clinically significant distress or impairment in social fxn
-five or more of the following sx have been present in the same two week and have atleast 1 of the symptoms as either :
-depressed mood or loss of interest or pleasure
-significant weight loss
-insomnia or hypersomnia
-psychomotor agitation or retardation
-fatigue/loss of energy
-feelings of worthlessness or excessive or inappropriate guilt
-diminished ability to think/concentrate /indecisiveness
-recurrent thoughts of death without or with a plan
-not attributed to effects of a substance
according to American Psychiatric Association, depression causes:
-loss of interest in activities you once u enjoyed which can decrease your ability to fxn @ home or work
sadness vs depression
sadness isa human emotion that is caused by emotional upset or pain BUT IT IS TEMPORARY.
-able to laugh or be comforted
pathogenesis of depression:
biological: family hx, medical illness
psychological:
-learned helplessness
-distorted cognitive interpretation that all things are bad
social:
-adverse childhood experiences
-isolation
what are some examples of distorted cognitive interpretation ?
” all things are bad:”
-ur life, u, everything
depression:
molecular theory
-abn. intracellular response to neurotransmitter:
[serotine, norepinephrine, dopamine]
-abn. gene expression that alters intracellular signal transduction
depression:
neuroendocrine theory
-alteration of hypothalmic pituitary adrenal axis such as [excretion of cortisol]
-hypothroxine
depression:
inflammation theory
elevated inflammatory markers-CRP, interleukin , TNF
[decrease in NT synthesis, dec. hippocampal, enhance neurotoxicity]
depression stats:
age:
f: m ratio:
age: 30 yrs
m:f- 2:1
what is the leading cause of disease burden, work disability, most pts untreated and death by suicide?
depression
depression risk factors
-comorbid conditions
-age [increases w age]
-income [lower income]
-marital status [divorce]
-race [white-na-hisp.-aa]
DSM-5 criteria : PERSISTENT DEPRESSIVE DISORDER [dysthymia]
A. depressed mood for most of the day for at least 2 YEARS [kids is 1 yr]
B. must have 2 or more sx:
-poor appetite
-insomnia or hypersomnia
-low energy or fatigue
-low self esteem
-poor concentration or difficulty making decision
-feeling of hopelessness
C. individual never been w/out sx for more than 2 months at the time
no effects of other substances, no manic episodes, no medical condition,
DSM-5 prolonged grief disorder
-persistent or pervasive grief response characterized by longing or yearning with 3/8 of the sx:
-disbelief
-intense emotional pain
-feeling of identity confusion w deceased
-numb
-intense loneliness
-meaninglessness
-difficulty engaging in ongoing life
DSM-5 criteria for seasonal affective disorder
-occurs during specific seasons for at least for 2 yrs
Depression screening:
if >3 most likely MDD
PHQ-2: inquires about depressed mood over the past 2 weeks
PHQ-9: screen depression
