Depressive disorders Flashcards

1
Q

neurovegetative symptoms of depression

A

somatic complaints

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2
Q

dysphoria

A

feeling sad/depressed/down

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3
Q

anhedonia

A

lack of pleasure

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4
Q

paradoxical suicide

A

committing suicide when symptoms are improving d/t increased energy to carry it out

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5
Q

MDD with psychotic features

A

delusions/hallucinations
specify if mood-congruent or mood-incongruent

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6
Q

MDD with melancholic features

A

depression w/ severe anhedonia, early morning awakening, weight loss, profound feelings of guilt

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7
Q

MDD with catatonic features

A

stupor
blunted affect
extreme withdrawal
negativism
marked psychomotor retardation

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8
Q

objective rating scales for depression

A

HAM-D (clinician-administered)
Zung (self-administered_
Raskin depression scale (both)

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9
Q

focus of cognitive therapy

A

identify and test reality of negative cognitions and practice new cognitive and behavioral responses

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10
Q

2 assumptions of interpersonal psychotherapy

A
  1. current interpersonal problems originate from previous dysfunctional relationships
  2. current interpersonal problems precipitate/perpetuate depressive symptoms
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11
Q

the gist of behavioral psychotherapy

A

by identifying and addressing maladaptive behavior patients can learn to function in a way that gets them positive reinforcement

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12
Q

goal of psychoanalytically oriented psychotherapy

A

change in personality structure/character for more than just to relieve symptoms

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13
Q

aims of psychoanalytically oriented psychotherapy

A

-interpersonal trust
-capacity for intamacy
-coping mechanisms
-capacity to grieve
-ability to experience a wide range of emotions

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14
Q

what is another term for dysthymic disorder

A

persistent depressive disorder

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15
Q

sx of dysthymic disorder in relation to those of MDD

A

not as severe but often more chronic

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16
Q

what is double depression

A

when criteria is met for both MDD and dysthymic disrder

17
Q

which type of medications are best to treat melancholic depressions

A

those that act dually on serotonin and norepinephrine

18
Q

what is considered a partial medication response

A

20-25% reduction in symptoms

19
Q

what is the effect of depression on the HPA axis

A

it is overactive leading to increased cortisol levels

20
Q

thyroid axis activity in depression

A

20-30% have blunted TSH response on challenge

5-10% have undiagnosed thyroid disorder

21
Q

what does BDNF stand for

A

brain-derived neurotrophic factor

22
Q

what does BDNF do

A

responsible for ongoing maintenance of neurons in the brain

23
Q

what happens when there is a disruption of BDNF in the brain

A

reduction in neuronal number and size

23
Q

agents that increase BDNF

A

antidepressants
estrogen
lithium
neurostimulation

23
Q

amygdala

A

a waystation for processing stimuli of emotional significance
and coordinating/organizing cortical responses

24
Q

what is adjacent to the amygdala
and associated with learning and memory

A

hippocampus

25
Q

What is L-sided activation of the PFC associated with

A

goal-directed or appetitive behavior

26
Q

what is right-sided activation of PFC associated with

A

avoidance behaviors and inhibition of appetitive pursuits

27
Q

which region of the brain is involved in attention, motivation, and environmental exploration

A

anterior cingulate cortex

28
Q

what structure in the brain regulated the HPA axis by inhibiting its activity

A

hippocampus

29
Q

what is the neurogenesis hypothesis of depression

A

chronic stress increases the activity of the HPA axis which increases glucocorticoid levels. glucocorticoids decrease neurogenesis. the hippocampus then cant regulate the HPA axis so glucocorticoids remain high and fewer neurons are produced leading to depression

30
Q

what is the neuroplasticity hypothesis of depression

A

neuronal atrophy causes depression rather than deficient growth. Atrophy is caused by increased glucocorticoid levels, which also decreases BDNF

31
Q

what are the 4 key points of the psychodynamic theory of depression

A

-disturbance in infant-mother relationship in the oral stage predisposes to depression vulnerability
-depression can be linked to real/imagined object loss
-unconscious thoughts of object as a defense mechanism to deal with distress connected to its loss
-feelings of anger are directed inward because lost object is associated with mixture of love and hate

32
Q

what is the cognitive theory of depression

A

depression results from specific cognitive distortions in someone susceptible to depression

33
Q

Aaron Beck’s cognitive triad of depression:

A

-views of self
-views of environment
-views of the future

34
Q

Triad of depression: views on self

A

tend to have a negative self-perception

35
Q

triad of depression: views on environment

A

tend to experience the world as hostile and demanding

36
Q

triad of depression: views of the future

A

tend to have expectations of suffering and failure

37
Q
A