depressive disorders

Question 1

Major depression diagnosis

Answer 1

five or more of the following nine have to be present for 2 weeks and represent a change in normal functioning. at least one has to be depressed mood or loss of interest or pleasure.

Question 2

what are the nine symptoms.

Answer 2

1. depressed mood most of the day. 2. markedly diminished interest or pleasure in all or most activities most of the day. 3. significant weight loss or gain more than 5%. 4. insomnia or hypersomnia nearly everyday. 5. psychomotor agitation or retardation that must be observable by others. 6. fatigue or loss of energy. 7. feelings of worthlessness or excessive inappropriate guilt. 8. diminished ability to think or concentrate. 9. recurrent thoughts of death.

Question 3

what is the nemonic for diagnosis of depression. stands for?

Answer 3

SIGECAPS

suicide, interest, guilt, energy loss, concentration/agitation, appetite, psychomotor, sleep disturbances.

Question 4

what is another nemonic

Answer 4

SWAG

suicide, weight loss/gain, anhedonia, guilt.

Question 5

seasonal affective disorder

Answer 5

MDD associated with the changing seasons mostly shorter days in the winter. usually has atypical symptoms.

Question 6

how to treat SAD

Answer 6

full spectrum light exposure, psychotherapy and antidepressants

Question 7

masked depression

Answer 7

depressed patients presenting with vague symptoms but are unaware or in denial of their illnesses. seem stoic.

Question 8

who is more likely to be seen with masked depression?

Answer 8

elderly patients who have either OCD or narcissistic personality

Question 9

what is monoamine theory of MDD

Answer 9

decreased levels of the monoamines DA, NE, 5HT. could have more receptors (excess theory). loss of neurotropic factors and degeneration theory as well.

Question 10

stress and cortisol theory

Answer 10

that increased stress produces higher levels of cortisol (glucocorticoids) which decrease the amount of brain-derived neurotropic factor within the brain. this causes atrophy or death of neurons. (should this be modified to say synapses?)

Question 11

who has a higher lifetime prevalence for depression?

Answer 11

women.

Question 12

what are the comorbidities for depression?

Answer 12

substance abuse and generalized anxiety

Question 13

what are the front line treatments for MDD

Answer 13

SSRI, SNRI, NDRI

Question 14

second line therapy

Answer 14

MAOi and TCA

Question 15

diurnal variations

Answer 15

mosre depressed in AM, better in PM. this is melancholic.

Question 16

pseudodementia

Answer 16

cognitive symptoms in depressed elderly pften misdiagnosed as dementia.

Question 17

atypical depression

Answer 17

more likely to have weight gain and hypersomnia. also has leaden paralysis, carb cravings and rejection sensitivity.

Question 18

what happens if a patient takes cortisol pills of autoimmune disorder?

Answer 18

they can get depressed because of BDNF>

Question 19

does depression get better or worse?

Answer 19

depression usually begets depression. `

Question 20

if erratic sleep schedule then prescribe which 5HT receptor blocker.

Answer 20

5HT1a for antihistamine sedation