Depressive Disorders Flashcards
Describe the DSM-V symptoms for Major Depressive Disorder
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
- Depressed mood
- Diminished pleasure in most activities
- Significant weight loss/gain
- Insomina/Hypersomnia
- Psychomotor agitation/retardation
- Fatigue
- Feelings of worthlessness
- Diminished ability to think/concentrate
- Recurrent thoughts of death
B. Syx cause clincially significant distress/impairment
C. Not caused by other substances/medical conditions
What is the mnemonic for Depression DSM criteria?
SMIG E CAPS
What does SMIG E CAPS stand for?
- Sleep Disturbance
- Interest/Pleasure Reduction
- Mood
- Guilt, Feelings of Worthlessness
- Energy Loss
- Concentration/Attention impairment
- Appetitie changes
- Psychomotor Syx
- Suicidal Ideation
How do you differentiate between normal sadness and depression? What is the mnemonic? What does it stand for?
SWAG
- Suicidality
- Weight Loss
- Anhedonia - loss of pleasure/interest in previously enjoyable activities
- Guilt
What is Atypical depression?
Shares many typical Syx of psychiatric MDD but shows improved mood in response to positive events; Weight gain, hypersomnia
What is pseudodementia?
Congnitive Syx in depressed elderly often misdiagnosed as dementia
What is diurnal variation MDD?
More depressed in AM, better in PM
What are psychomotor Syx of MDD?
Body aches, headaches, agitation, retardation, vegetative
What is seasonal affect disorder?
MDD associated with shorter days in the winter often including atypical Syx
Tx for Seasonal Affective Disorder?
Full-spectrum light exposure, psychoTx, Antidepressants
Settings in which masked depression is observed
Stoic, elderly, OCD, narcissistic personalities
What medical conditions can present with depressive Syx?
Hypothyroid, Cushing’s, Anemia, Brain injury/stroke, Vit deficiency, obstructive sleep apnea
What are the two primary biologic theorys of depression?
Monoamine Deficiency, Monoamine Receptor Excess Theory
Describe the Monoamine Deficiency theory
There are decreased levels of Dopamine, Serotonin, and Norepinephrine
Describe the Monoamine Receptor Excess Theory
If you have too many receptors, the brain sees less seritonin communication because you have too little transmitter to fill the receptors!
How are HT receptors pharmologically downregulated?
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.
Which has a greater influence from psychosocial influence, Depression or Bipolar?
Depression. Bipolar, Schiz have more of a genetic impact.
Relationship betwixt number of depressive episodes and monthly risk of depression onset.
The more depressive episodes, the greater monthly risk of depressive onset
How does stress affect your brain?
Increased stress, decreased brain derived neurotrophic factor, atrophy/death of neurons.
What part of the brain runs hot in depression? What is cold? What is running amoc?
Amygdala; Frontal lobe; Limbic system
In which gender is depression more common?
Women
What are the front lines in depression Tx?
SSRI, SNRI, NDRI, MAOI
What is melancholic depression?
Depression with melancholic affect with anhedonia, lack of mood reactivity
