HYHO Depression + Anxiety

Question 1

Who/where is the prevalence of depression the highest?

Answer 1

where - developed countries

who - females (2x greater then males)

Question 2

What medical conditions are associated with depression?

Answer 2

TBI

Heart Dz

stroke

DM

COPD

Arthritis/ongoing pain

Cancer

Obesity

Question 3

What is the diagnostic criteria for a major depressive episode?

Answer 3

5+ of sx for at least 2 weeks

depressed mood

loss of interest

insomnia

weight loss/gain

psychomotorretardation or agitation

fatigue

dec concentration

guilt

suicidal ideation

Question 4

What psych probs often co-occur with GAD?

Answer 4

social phobia

specific phobia

panic disorder

also assoc with: inc rates of sub abuse, PTSD, OCD

Question 5

How do you dx GAD?

Answer 5

worry present most days for at least 6 months

difficult to control worry

3/6 sx: restlessness, easily fatigued, difficulty concentrating, irritable, muscle tension, sleep disturbance

clinically significant distress

no better explained by other disorder

Question 6

__ is the best way to dx depression/anxiety.

Answer 6

history

use family member to augment hx

family hx may hint at certain dx (ex. pt with a family hisotry of bipolar disorder is at inc risk of suicide)

Question 7

All depressed pts must be asked about ___.

Answer 7

suicidal ideation

if positive response:

1. ask about specific nature of ideation/plan/means
2. assess RFs for suicide
3. develop safety plan

Question 8

___ is often underdiagnosed in pts who present with depressive syndromes.

Answer 8

bipolar disorder

Question 9

How can you distinguish between schizophrenia/schizoaffective disorder and a unipolar psychotic depression?

Answer 9

schizophrenia/schizoaffective disorder - psych sx can/do occur in absence of major depression

unipolar psychotic depression - delusions/hallucinations occur only during an episode of major depression

Question 10

In pts with major depression tx with psychotherapy, you should consider …

Answer 10

CBT or interpersonal psychotherapy rather than other psychotherapies

Question 11

When should you consider a psych referral?

Answer 11

dx is uncertain

depression endangers life

severe, psychotic, and catatonic depression

depression associ with other psych dx

Question 12

What GAD pts are best aided by CBT?

Answer 12

younger >> older

also, pts with severe depression may be unable to engage

Question 13

What is the five model approach to depression?

Answer 13