Lectures 10 & 11-Depression Flashcards
To dx major depressive disorder ____ (or more) of the following nine symptoms have been present during the same ___-week period and represent a change from previous functioning; at least one of the symptoms is either _____ mood or ____ of interest or pleasure.
- depressed mood
- loss of interest or pleasure
- weight gain/ loss or decrease/ increase in apetite
- Insomnia/ hypersomnia
- Psychomotor agitation or retardation
- Fatigue
- Worthlessness or inappropriate guilt (delusional)
- Diminished concentration & decision making
- Recurrent thoughts of death, suicide+/- plan
five; 2; depressed; loss
Easy mnemonic to remember DSM depression criteria:
SIG-E-CAPS
S leep disturbance
I nterest/pleasure reduction
G uilt, feelings of worthlessness
E nergy loss, fatigue
C oncentration/attention impairment
A ppetite changes
P sychomotor symptoms
S uicidal ideation
Mnemonic _____ is used to differentiate between normal sadness and depression (have at least 1 of the following)
SWAG;
Suicidality – serious thoughts (ideation) or attempts at killing oneself
Weight Loss – >5% loss of body weight w/o medical cause
Anhedonia – loss of pleasure/interest in previously enjoyable activities
Guilt – feeling responsible for negative life events w/o reason
Other Characteristics of MDD: Atypical depression – more likely to have ____ gain and ___somnia
weight; hyper
Other Characteristics of MDD: Pseudodementia – cognitive symptoms in depressed _____ often misdiagnosed as “dementia” (short term memory loss)
elderly
Other Characteristics of MDD: Diurnal variation _____ depressed in AM, better in PM. Melancholic type depression (complete _____ with early morning wakening)
more; antodonia
Other Characteristics of MDD: Psychomotor symptoms– _____ complaints: body aches, headaches; Can be ______ or Retardation
physical; Agitation
What is seasonal affective disorder? Treatment?
Seasonal Affective Disorder (SAD)
MDD usually associated with shorter days in winter
Treat with full-spectrum bright light exposure therapy, psychotherapy, antidepressants
What is masked depression?
Depressed patients presenting with vague physical ailments but unaware/in denial of their depression
Seem stoic
Seek primary care for psychomotor or somatic symptoms instead
More typically seen in elderly patients, obsessive-compulsive/narcisstic personalities, eastern europeans
Biological causes of depression:
- Monoamine ____ levels of Dopamine (DA), Serotonin (SR), Norepinephrine (NE)
- Monoamine Receptor _____ Theory (receptor _____ due to low amount of monoamines)
- ____ of neurotrophic factors and neurodegeneration?
- ____ transporter gene
Deficiency; Excess; upregulation; Loss; Serotonin
Psychosocial causes of depression?
Ability to cope with life stressors – Resilience
Low self esteem, negative outlook
Personality traits
Addiction
Learned helplessness
Catastrophic loss
Anger turned inward? = I am mad at someone for sitting in my seat and I get mad at myself
Incapacity via
hibernating? = Incapacity via hibernating = quit med school to be engineer, parents were docs
Learned helplessness and automatic thoughts?
Social disconnect?
High # of receptors and/or low # of transmitter = ____
Depression
Are there both Genetic and Environmental Risk Factors in Depression?
yes
More depressions make you get into a state of depression (get stuck)—so intervene ____
Depression may be a neurodegenerative disease, as you get _____, you get more depressed
early; older
In neurodegenerative hypothesis of depression antidepressants that affect serotonin and/or norepinephrine activity may affect neuronal survival and growth by decreasing glucocorticoid levels and ____ BDNF levels.
increasing
