Depressive Disorders

Question 1

Describe the DSM-V symptoms for Major Depressive Disorder

Answer 1

A. 5 or more of 9 Syx present during same 2-week period and represent change from previous function; At least one of Syx is either depressed mood or loss of interest of pleasure

1. Depressed mood
2. Diminished pleasure in most activities
3. Significant weight loss/gain
4. Insomina/Hypersomnia
5. Psychomotor agitation/retardation
6. Fatigue
7. Feelings of worthlessness
8. Diminished ability to think/concentrate
9. Recurrent thoughts of death

B. Syx cause clincially significant distress/impairment

C. Not caused by other substances/medical conditions

Question 2

What is the mnemonic for Depression DSM criteria?

Answer 2

SMIG E CAPS

Question 3

What does SMIG E CAPS stand for?

Answer 3

1. Sleep Disturbance
2. Interest/Pleasure Reduction
3. Mood
4. Guilt, Feelings of Worthlessness
5. Energy Loss
6. Concentration/Attention impairment
7. Appetitie changes
8. Psychomotor Syx
9. Suicidal Ideation

Question 4

How do you differentiate between normal sadness and depression? What is the mnemonic? What does it stand for?

Answer 4

SWAG

1. Suicidality
2. Weight Loss
3. Anhedonia - loss of pleasure/interest in previously enjoyable activities
4. Guilt

Question 5

What is Atypical depression?

Answer 5

Shares many typical Syx of psychiatric MDD but shows improved mood in response to positive events; Weight gain, hypersomnia

Question 6

What is pseudodementia?

Answer 6

Congnitive Syx in depressed elderly often misdiagnosed as dementia

Question 7

What is diurnal variation MDD?

Answer 7

More depressed in AM, better in PM

Question 8

What are psychomotor Syx of MDD?

Answer 8

Body aches, headaches, agitation, retardation, vegetative

Question 9

What is seasonal affect disorder?

Answer 9

MDD associated with shorter days in the winter often including atypical Syx

Question 10

Tx for Seasonal Affective Disorder?

Answer 10

Full-spectrum light exposure, psychoTx, Antidepressants

Question 11

Settings in which masked depression is observed

Answer 11

Stoic, elderly, OCD, narcissistic personalities

Question 12

What medical conditions can present with depressive Syx?

Answer 12

Hypothyroid, Cushing’s, Anemia, Brain injury/stroke, Vit deficiency, obstructive sleep apnea

Question 13

What are the two primary biologic theorys of depression?

Answer 13

Monoamine Deficiency, Monoamine Receptor Excess Theory

Question 14

Describe the Monoamine Deficiency theory

Answer 14

There are decreased levels of Dopamine, Serotonin, and Norepinephrine

Question 15

Describe the Monoamine Receptor Excess Theory

Answer 15

If you have too many receptors, the brain sees less seritonin communication because you have too little transmitter to fill the receptors!

Question 16

How are HT receptors pharmologically downregulated?

Answer 16

HT hyperstimulates HTRs. The nerve then downregulates the HTRs. It takes 4 to 6 weeks likely due to a lot of gene activation/stimulation/change.

Question 17

Which has a greater influence from psychosocial influence, Depression or Bipolar?

Answer 17

Depression. Bipolar, Schiz have more of a genetic impact.

Question 18

Relationship betwixt number of depressive episodes and monthly risk of depression onset.

Answer 18

The more depressive episodes, the greater monthly risk of depressive onset

Question 19

How does stress affect your brain?

Answer 19

Increased stress, decreased brain derived neurotrophic factor, atrophy/death of neurons.

Question 20

What part of the brain runs hot in depression? What is cold? What is running amoc?

Answer 20

Amygdala; Frontal lobe; Limbic system

Question 21

In which gender is depression more common?

Answer 21

Women

Question 22

What are the front lines in depression Tx?

Answer 22

SSRI, SNRI, NDRI, MAOI

Question 23

What is melancholic depression?

Answer 23

Depression with melancholic affect with anhedonia, lack of mood reactivity