Depressive DIsorders Flashcards
Depressive Disorderes
DM 5 list (shortened)
- Major Depressive Disorder (MDD)
- Persistent Depressive DIsorder
- Pre-Menstrual Dysmorphic Disorder
- Disruptive Mood Dysregulation Disorder
- Substance/Med-induced
Depression vs Sadness
Depression = less/unresponsive to positive environmental stimuli
MDD
Dx
5+ s/s for MINIMUM 2 WEEKS (change from previous functioning)
- Depressed mood
- Loss of interest to activities
- Weight change
- Insomnia/hypersomnia
- Psychomotor agitation/retardation
- Energy loss
- Less concentration
- Guilt/worthlessness
- Death/suicide thoughts
Depression Is Worth Studiously Memorizing Extremely Grueling Criteria, Sorry.
MDD
DSM specifiers
- anxiety
- mixed features
- melancholic features
- anxiety
- min 2 s/s
- mixed features = manic-like, but not timeline for bipolar, can develop to bipolar
- melancholic features = pleasure loss, worse in morning
2ndary depression
- drug
- metabolic
- Neuro
- Pancreatic cancer
- drug = opioid
- metabolic = hypothyroidism
- Neuro = Parkinson’s, tumor, stroke
- Pancreatic cancer = interleukins
MDD
MC comorbidities
Anxiety disorder
Substance Use
Personality Disorder
Also: med condition, environ stress, dysthmia (double depression)
MDD
Endocrine bases
Cortisol not shutting down when chronically flooding brain
MDD
Striatum
sluggish movement
MDD
Neocortex
Concentration
MDD
Amygdaloid Body
Anxiety
MDD
Hypothalamus
Sleep Appetite
MDD
Hippocampus
Memory problems
Best chance of full remission w/ patients who
pursue Tx
ADDs good for actute/longterm Tx?
long-term
Suicide
Investigate:
- Plan?
- Plan lethality?
- Access to means?
- Intent?
- Oppose/Accept plan?
- Social Support?
- 24/7 Observation?
- Comorbidity?
MDD
Who?
Female
White
Old
Widow
MDD
Treatment
Mild/Moderate = ADDs
Severe = ADD + Psychotherapy
Refractory = Transcranial Magnetic Stimulation (TMS), Electroconvulsive Therapy (ECT)
ADD treats ____ s/s
Psych (1st ) + Somatic s/s
MDD
Thought distortion
Give too much value to unrealistic thought
Depressed mood + 2 other depressive s/s FOR 2 YEARS+
- +/- periods of major depression (double depression)
- NO if d/t substance/med
Persistent Depressive Disorder (Dysthymia)
Dx
Severe temper outbursts w/ underlying persistent angry mood
- 3+ outbursts/week
- Irritable mood + outbursts AT LEAST 1 YEAR
- Before 10 y/o (NO dx after 18 y/o)
- NO w/ ODD
Disruptive Mood Dysregulation Disorder (DMDD)
Dx
DMDD
Who?
males
DMDD
Tx
Cognitive behavioral Therapy (children)
MDD
Exclude for Bereavement/Grief?
NO
depression s/s LESS than 2 months after death of loved one
5 s/s + at least one (*) MIN 2 cycles ***Affective Lability*** ***Irritability*** ***Depressed mood*** ***Anxiety/ Tension*** *decreased interest *Poor concentration *Fatigue *appetite change *hypersomnia/insomnia *overwhelmed *breast/joint tenderness, weight gain
Premenstrual Dysphoric Disorder
Mania = s/s MIN 1 WEEK
Hypomania = s/s MIN 4 days
NO d/t RX
3+ s/s:
- grandiosity
- Less sleep need
- Pressured speech
- DIstractability
- UP activity, agitation
- Consequential Behavior
- NO d/t Rx
Mania/Hypomania
Dx
MUST HAVE:
- lost of pleasure
- inability to respond to pleasurable stimuli
+3
- Depressed mood
- worse in morning (diurnal variation)
- Terminal insomnia
- psychomotor agitation
- weight loss
- guilt
DM specifiers
Melancholia
Bereavement vs. Depression
Now classified as Major depression if meet timeline
DO NOT need extreme severity or suicide.
Seen as trigger to episode
ADD meds work
Catecholamine hypothesis
NE lack is cause of Depression
