Depressive Disorders

Question 1

The symptoms of Disruptive Mood Dysregulation Disorder are:

Answer 1

Chronic irritability with frequent outbursts for at least one year with no more than 3 months without outbursts.

• Onset is before age 10. Often diagnosed between ages 6 and 18

Question 2

The symptoms of Major Depressive Disorder are:

Answer 2

Experience **at least 5 ** of the following symptoms for a sustained 2-week period:
* Persistent negative mood
* Diminished satisfaction / pleasure
* Significant weight loss
* Insomnia / hypersomnia
* Agitation
* Fatigue
* Feelings of worthlessness
* Difficuly concentrating
* Suicidal ideation

Question 3

Some features of depression include:

Answer 3

• Atypical features:
  
  • Temporarily cheered by happy events
  • Increased appetite
  • Excessive need for sleep
  • Rejection sensitivity
  • Heaviness in the arms or legs
• Psychotic features:
  
  • Delusions
  • Hallucinations
• Catatonia - motor activity
• Seasonal pattern - Related to changes in seasons and reduced exposure to sunlight

Question 4

Medications that are commonly prescribed for depression include:

Answer 4

Selective serotonin reuptake inhibitors (SSRIs)
* Citalopram (Celexa)
* Escitalopram (Lexapro)
* Fluoxetine (Prozac)
* Paroxetine (Paxil, Pexeva)
* Sertraline (Zoloft)
Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)
* Duloxetine (Cymbalta)
* Venlafaxine (Effexor XR)

Atypical antidepressants
* Bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL)
* Nefazodone
* Trazodone

Tricyclic antidepressants
* Imipramine (Tofranil)
* Nortriptyline (Pamelor),
* Doxepin
* Desipramine (Norpramin)
These drugs can be very effective, but tend to cause more-severe side effects than newer antidepressants.

Monoamine oxidase inhibitors (MAOIs)
* Tranylcypromine (Parnate)
* Phenelzine (Nardil)
* Isocarboxazid (Marplan)
NOTES:
* MAOIs may be prescribed, typically when other drugs haven’t worked, because they can have serious side effects.
* Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods — such as certain cheeses, pickles and wines — and some medications and herbal supplements.
* These medications can’t be combined with SSRIs.

Question 5

These therapeutic techniques most suitable for depression:

Answer 5

• Psychotherapy
• Cognitive therapy
• Mindfulness-based cognitive therapy
• Behavioral therapy
• CBT
• Interpersonal therapy - improving problematic relationships and circumstances that are most closely linked to the current depressive episode