Depression |X Flashcards
Is depression in the elderly more common in M or F?
F
What is the prevalence of depression in the elderly in the community?
1 in 5
What are the aetiology of depression in the elderly?
- Biological (4)
- Psychological (3)
- Social (4)
Biological
- Chronic pain e.g. arthritic/neuropathic pain
- Long term conditions
- Recent physical illness
- Medications ( steroids)
Psychological:
- Previous history of depression or anxiety
- Loss
- mobility/relatives/independence etc - High level of independence
Social:
- Social isolation
- Widowed, esp for men
- Not able to drive/poor mobility
- Elderly neighbours
What are the presentations of depression in the elderly (6)?
- Reduction in activity - slowing down
- Depressive and suicidal thoughts
- Agitation e.g. tugging at clothes
- ## Psychosomatic complaints
- Poor memory
- Self neglect
Symptoms distinguishing between depression and dementia?
Depression
- Feeling low and negative most of the time
- Lack of motivation
- Suicidal thoughts
- Low appetite, poor sleep
- Onset: 2 weeks
- Have insight
- ST problems but LT intact
- Drops in MOCA i.e. cognition
Dementia
- Feeling low
- Lack of motivation
- Poor sleep
- Onset: insidious, 6 month
- Lack of insight
- Have ups and downs but more consistent in mood
- ST problems but LT intact
- Drops in MOCA i.e. cognition
What is the diagnosis of depression?
- Mild
- Moderate
- Severe
Mild
- Core: +2
- Other: +2
- Somatic:
- Psychosis: No
- Impact: Minimal
Moderate
- Core: +2
- Other: +3
- Somatic
- Psychosis No
- Impact: Significant
Severe
- Core: +3
- Other: +4
- Somatic
- Psychosis Yes
- Impact: Severe
What are the 3 core symptoms?
What are 5 other symptoms?
What are somatic symptoms (7)?
Core:
- Low mood
- Fatigue
- Anhedonia
Other:
- Guilt
- Suicide
- Self esteem
- Hopelessness
- Conc+attention
Somatic:
- Appetite
- Weight loss (>5%)
- Libido
- Diurnal variation
- Retardation/agitation
- EMA
- Sleep disturbance
How would you ask about fatigue (2)?
Do you feel more tired than usual?
Do you feel more tired doing normal activities like stairs, than you have in the past?
How would you ask about anhedonia (3)?
Do you still enjoy doing the things you used to enjoy?
Do you feel joy in anything?
What is the impact of that on you?
How do you ask about guilt?
Is there anything you blame yourself for?
How would you ask about low mood (2)?
How are you feeling in your mood?
Are you feeling low?
How do you ask about appetite (4)?
Do you still enjoy/look forward to food?
Has the way you prepare food changed?
How many meals do you eat?
What do you usually eat?
How do you ask about libido?
Are you still having sexual urges?
Intimate relationship with spouse?
How do you ask about diurnal variation (2)?
Is there any time of day you feel low?
Does your mood change at certain times of day?
How do you ask about sleep cycle (5)?
Even if sleep is disturbed, can you get back to sleep? Can you get of to sleep Do you wake up from sleep? What time do you wake up? Do you feel rested?
