DSM-5-TR - Depressive Disorders

Question 1

Major Depressive Disorder

Answer 1

REQUIRES
* 1 Major Depressive Episode (MDE) - [5+ Sx, 2wk period, at least 1 being depressed mood or anhedonia]
* No Manic/Hypomanic Epi

Onset | Recovery
* Peaks in 20s (any age)
* Course of is variable
* Factors associated w/ low recovery include: epi duration, psychotic features, prominent anxiety, PDs, Sx severity
* Risk of recurrence high when: preceding epi severe, younger, people have had multiple epi(s)

Numbers | Heritability
* [Prepuberty] girls = boys
* [Early adol] girls:boys - 2:1
* IDENTICAL Twins - 55-60%
* FRATERNAL Twins/Sibs - 20%
* Risk Factors include - neuroticism (neg affect), ACES, stressful life events | possiblity of SI at all times during epi

Interventions/Treatments
* CBT
* Interpersonal Therapy
* Behavior Therapy/Behavioral Activation
* ACT
* Self-Management/Self-Control Therapy (SST)

Medications*

Question 2

Death by Suicide*

Answer 2

CDC
* Top 9 leading causes
* 2nd leading ages 10-14 & 25-34
* Increase by ^30% in last 2 decades
* Completion 3/4M:F | Attempts 3F:M
* Veterans/Sexual Minorities higher risk

Ages
* Highest - 75+ (19.1), 25-34 (18.4)
* Lowest - 15-24 (14.2), 65-74 (14.5)

Ethnicity
* Highest - Natives/Indigenous (23.9), White (16.9)
* Much Lower (7) - Black, Hispanic, Asian

Disorders [mood, schiz, PDs, sub use]

Best Predictor | Risk Factors
* History of serious suicide attempts
* Greatest risk immediately following hospitalization
* Male, single, living alone
* Family history of suicide, chronic pain/illness
* Criminal/legal problems, financial loss
* Expressions of hopelessness stronger than presence/severity of depression

Question 3

Postpartum Depression
Postpartum Blues
Postpartum Psychosis

Answer 3

Postpartum Dep (w/ Peripartum onset) | 10-15% new mothers
* for months if untreated

Postpartum Blues | 50%-80% of mothers
* less severe, short-lived

Postpartum Psychosis | .2%
* hallucinations [commands to kill/harm infant]
* delusions [beliefs infant is possessed/special powers]

Question 4

MDE vs. Grief*

Question 5

Disruptive Mood Dysregulation Disorder

Answer 5

• Recurrent verbal or physical outbursts
• Avg 3+/wk, over 1 year, 2 settings
• Mood is irritable/angry nearly every day
• Dx before 18, Sx present before 10

Question 6

Persistent Depressive Disorder

Answer 6

• Dep mood nearly every day
• AT LEAST 2 years (1 in child/adol)
• 2 or more – change in app, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concen or difficulty making decisions, feelings of hopelessness
• Early, insidious onset, chronic course

No manic/hypomanic can rule out cyclo

Question 7

Premenstrual Dysphoric Disorder

Answer 7

• present in week before onset of menses
• improve start of
• absent in the week after

Question 8

Depressive Disorder
due to another med condition

Answer 8

Can be caused by:
* Stroke
* Huntington’s
* Parkinson’s
* TBI

Neuroendocrine Conditions:
* Hypothyroidism
* Cushin’s disease