Depressive Disorders, Weiss Flashcards

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1
Q

depressive disorders more common in M or W

A

W

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2
Q

age onset depresstion

A

40 y.o average

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3
Q

cause depression

A

unknown

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4
Q

causative factors for depression

A

biological
genetic
pyschosocial

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5
Q

biological factors for depression

A

dysregulation with NT
neuroendocrine dysregulation of adrenal or thyroid axis
growth hormones etc

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6
Q

genetic factors for depression

A

pattern unknown
1st degree relatives 2-10 x more likely
50% monozygotic twins

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7
Q

psychosocial factors for depression

A
stressful events
premorbid personality factors
learned helplessness
cognitive theory
psychodynamic theory
early childhood trauma
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8
Q

what is dysthymia

A

peristent depressive disorder that is chronic low grade

does not respond well to antidepressants

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9
Q

tyeps of depressive disorders

A
major, single
major, recurrent
persistent depressive disorder
substance. med induced
premenstrual dysphoric disorder
depressive from another medical condition
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10
Q

Dx depression

A

significant distress with funcitonal impairment

not due to direct physiological effects of a substance

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11
Q

major depressive disorder

A

at least a depressed mood or anhedonia(lack of interest of pleasurable activity)
at least 2 weeks
at least 4 Sx

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12
Q

clinical features depression

A
depressed mood
marked dec interest
dec/inc appetite, weight change
sleep disturbance
psychomotor agitaiton/retardation
loss of E
guilt, worthlessness
poor concentration, indecisiveness
recurrent thoughts of death, suicidal thoughts
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13
Q

mental status exam general description

A
appearance, hygiene
level cooperativeness
eye contact
posture
pyschomotor agitation/retardation
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14
Q

mental status exam

A
speech
perceptual disturbances
thought content
suicidal thoughts
orientation
memory
concentration
attention
judgement, insight, reliability
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15
Q

what general medical conditions can lead to depression

A

infections, endocrine disorders, inflammatory disorders, neuro disorders, vitamine deficiencies
neoplasms

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16
Q

course of depression

A

chronic relapsing

17
Q

poor pronostic indicators for depression

A

coexisting dythymic disorder, alcohol abuse, anxiety disordesr, multiple episodes, hospitalizaiton, men, poor support, late age initial onset, personality disorder, psychotic component

18
Q

first decision when Tx depressed patient

A

safety

do need to hospitalization, at risk of self?

19
Q

risk factors for suicide

A
male
elderly
caucasian
Hx previous attempts
co morbic medical illness
drug/alcohol abuse
comorbid psych illness
social isolation
low job satisfaction, financial stress
20
Q

risk factors for suicide

A
male
elderly
caucasian
Hx previous attempts
co morbid medical illness
drug/alcohol abuse
comorbid psych illness
social isolation
low job satisfaction, financial stress
21
Q

Tx for depression

A

hospitalization vs outpatient
complete Diagnostic eval
establish plan
psychosocial therapies

22
Q

pharmacotherapy depression

A

TCA, SSRI, SNRI, MAOI, bupropion, mirtazapine, atypical antipsychs, augmenting: lithium, thyroid, stimulants and combinations

23
Q

what TCA are used in depression

A

nortriptyline
amitriptyline
imipramine
desipramine

24
Q

SSRIs for depression

A
fluoxetine
paroxetine
sertraline
citalopram
escitalopram
fluvoxamine
25
Q

what is first line for depression

A

SSRI

26
Q

MAOI for depression

A

phenelzine
selegiline
tranylcypromine
isocaroxazid

27
Q

SNRI used in depression

A

venlafaxine
duloxetine
desvenlafaxine

28
Q

side effect venlafaxine

A

HTN

29
Q

Bupropion

A

dec seizure threshold significantly

no sexual dysfunction with this drug

30
Q

mirtazapine

A

great for elder woman not eating or sleeping

no sexual dysfunction

31
Q

lithium warning

A

can overdose easily, low therapeutic index

32
Q

major side effects of antidepressants

A
GI
sexual
withdrawal flu
weight gain
seizure threshold
HTN
sedation/stimulation