Depressive disorders Flashcards
what are the lab findings that have been identified that are diagnostic of MDD?
none
what are the DSM 5 diagnostic criteria for a major depressive disorder?
for at least 2 weeks, 5 or more of these symptoms, at least one of which is depressed mood or loss of interest / pleasure:
- depressed mood most of the time, most days
- anhedonia
- significant change in appetite or weight
- significant change in sleeping habits
- psychomotor agitation or retardation
- fatigue or loss of energy
- feelings of worthlessness, or excessive guilt
- diminished ability to concentrate or make decisions
- recurrent thoughts of death or suicide
what is the average age of onset for MDD?
mid 20s (but could begin at any age)
what predicts recurrence for MDD?
presence of residual symptoms
what are the ddx for MDD?
- normal sadness
- grief
- adjustment disorder with depressed mood
- persistent depressive disorder (dysthymia)
- manic episode with irritable mood or mixed features
- dementia
- mood disorder due to a general medical condition
- substance induced mood disorder
how do you differentiate depressive disorders?
- disruptive mood dysregulation disorder
- MDD (one or more MDEs without any manic, hypomanic, or mixed episodes)
- premenstrual dysphoric disorder
- other specified / unspecified depressive disorder
how are criteria for met for MDD with mixed features?
having BOTH a depressive episode and a manic episode simultaneously for at least a week
what are the primary treatment strategies for MDD?
- psychopharmacology
- psychotherapy
what are the general principles of pharmacological anti-depressants?
- black box warning for suicidality
- onset of action
- 20% in 2 weeks / measured care
- response versus remission
- anxiolytic properties
- compliance
what drug class is the most common first line treatment for depression?
SSRIs
is there such thing as a “stronger” or “weaker” antidepressant?
NO - efficacy / potency is patient dependent
