Ger 5 Depression Flashcards
What is major depression according to the diagnostic and statistical manual of mental disorders?
5 or more symptoms during same 2 week interval
- Depressed mood
- Loss of interest or pleasure in previously pleasurable activities
- ONE OF THESE 2 MUST BE PRESENT
- Significant weight loss or weight gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthlessness or inappropriate guilt
- Impaired concentration
- Recurrent thoughts of death
What are the existing symptoms of depression viewed as?
Significantly impairing QOL and performance of ADLs
What is symptoms are required for the diagnosis of dysthymia?
2 or more of the following:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Fatigue
- Low self-esteem
- Impaired concentration
- Feelings of hopelessness
What is the other requirement for a diagnosis of dysthymia?
-Experience depressed mood for most of the day, more days than not, across an interval of at least 2 years, and not be asymptomatic for longer than 2 months during the 2 year course of illness
What is double depression?
A diagnosis of dysthymia and major depression
What are the risk factors for depression?
- Living environment
- Comorbidity (multiple medical conditions)
- Chronic Disease
- Factors associated with chronic disease
What % of elderly people are depressed that live at home?
13.5%
What % of elderly people are depressed that live in nursing homes?
20.3%
What % of nursing home residents admitted from home were depressed?
34.3%
What % of nursing home residents admitted from the hospital were depressed?
19.7%
What % of nursing home community patients had dysthymia?
1.7%
What % of patients living in their home had dysthymia?
17.9%
What is the general trend with living environment and depression?
Those living at home (generally alone) have a higher incidence of depression
The study presented regarding chronic disease and depressive disorder symptoms included what chronic conditions?
Asthma, COPD, gastric problems, arthritis, and heart failure
What % range of individuals had chronic disease and depressive disorder symptoms?
13.7% - 24.2%
What % of individuals had depressive disorder symptoms and NO chronic disease?
7.5%
What was the conclusion of the study regarding the relationship between chronic disease and depressive disorders?
The chronic diseases frequently reported by older adults (55+) may increase the likelihood of depressive disorder
What are risk factors for chronic disease associated with depressive disorders?
- Smoking
- Obesity
- Impoverished
- Received a diagnosis of diabetes, heart disease, or stroke
- Decline in physical activity over a 3-year interval
What is a big risk factor for depression in geriatrics?
COMORBIDITY
Are patients who are depressed more likel to report a substantial improvement in self-rated health?
NO…Patients who are depressed are less likely to report a substantial improvement in self-rated health and more likely to report a substantial decline
What is depression associated with in regards to ADLs?
Disability in the cognitive and physical activities of daily living
What is the relationship between long-term symptoms of depressive disorder and health among older residents of communities?
INVERSE
Is diagnosis of depression an independent risk factor for mortality among patients with acute coronary syndromes?
YES
Is depression an independent risk factor for mortality in general?
YES
By 2020, where will depression be ranked in its contribution to the global burden of disease as measured by disability-adjusted life years?
Second to heart disease
What is a depressive disorder?
Syndromes characterized by the impairment of mood regulation
What are the 2 most common depressive disorders?
- Major depression
2. Dysthymia
What is dysthymia?
A disorder characterized by chronic low mood
What are depressive disorders also characterized by, specific to geriatrics?
Impairment in cognition (pseudodementia) and by psychomotor agitation or retardation
Is the prevalence of major depression generally lower among older adults than among young adults?
YES
- Older adults: 0.9%
- 45-64: 2.3%
- 30-44: 3.9%
Are suicide rates higher in older or young adults?
OLDER
Have the rates of major depression increased over the past decade?
Yes… markedly
Is depression an expected part of aging?
NOPE
What is another effect of SSRIs that might be applicable in a geriatric population?
SSRIs are though to inhibit platelet activity, which may protect the heart independent of its use as an antidepressant
