MDD Flashcards
Learn MDD Criteria
1 in how many people will experience some form of depression or anxiety in their lifetime.
5
2015/16 statistics show that psychological distress including anxiety and depression is significantly higher among Maori by what %
10.5%
2015/16 statistics show that psychological distress including anxiety and depression is significantly higher among Pacific by what %
11.3%
2015/16 statistics show that psychological distress including anxiety and depression is 6.4% in what ethnicity
New Zealand European
2015/16 statistics show that psychological distress including anxiety and depression is 6.1% for what ethnicity
Asian
Psychological distress was highest among those of what age?
15-24 years (8.8%)
2nd highest age group of Psychological distress?
25-34 years (8.4%)
psychological distress was higher among which gender
across all age groups
Female
Causes of MDD SFhPCtMSi
Stressful events (i.e. breakup of a relationship or financial trouble)
A family history of depression (genetics)
Physical illness
Stressful or traumatic events in childhood can lead to depression in later life
Particular medications can cause depression
in some people
Social isolation i.e. lack of support from friends and family
DIAGNOSTIC CRITERIA Intro
Five (or more) of the following symptoms have been present during the same 2 week period and represent a change from previous functioning;
at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure
DIAGNOSTIC CRITERIA
Depressed mood
Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (
Note: In children and adolescents, can be irritable mood.)
DIAGNOSTIC CRITERIA
Markedly diminished interest
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every
day (as indicated by either subjective account or observation.)
DIAGNOSTIC CRITERIA
Significant
Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of bodyweight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
DIAGNOSTIC CRITERIA
Sleep behavior
Insomnia or hypersomnia nearly every day.
DIAGNOSTIC CRITERIA
Psychomotor agitation
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
DIAGNOSTIC CRITERIA
How often does fatigue occur?
Fatigue or loss of energy nearly every day.
DIAGNOSTIC CRITERIA
Feelings of worthlessness
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly everyday (not merely self reproach or guilt about being sick).
DIAGNOSTIC CRITERIA
What happens to concentration?
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
DIAGNOSTIC CRITERIA
Death
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Issues in diagnoses
What percentage of people who have depression also have anxiety disorder?
50%
Issues in diagnoses
What percentage of people who have depression also have an SUD
20%
Issues in diagnoses
Can Depression be a relapsing condition?
Yes
Issues in diagnoses
What is common with Sub Threshold symptoms of Depression
It is common for people to experience sub-threshold symptoms between episodes i.e they do not meet all the criteria for the diagnosis yet remain disabled by the condition.
Issues in diagnoses
What about culture can affect diagnoses?
Culture plays a part in how depression is expressed e.g. some people will report primarily bodily based symptoms rather than emotional or cognitive symptoms
What is Grief?
GRIEF
The grieving process is natural and unique to each individual and shares some of the same features of depression like intense sadness and withdrawal from customary activities.
Expression of grief vs depression (mood)
grief: painful feelings come in waves, often intermixed with positive
memories of the deceased.
Depression: mood and thinking are almost constantly negative.
Expression of grief vs depression (self esteem)
Grief: Self esteem is usually preserved
Depression: corrosive feelings of
worthlessness and self-loathing are common
SCREENING
Be alert to depression in people with a past history of depressive episodes and people with co-occuring long-term physical health conditions that impair daily living. ASK?
During the last month, have you often been bothered by feeling down, depressed or hopeless?
During the last month, have you often been bothered by having little interest or pleasure in doing things?
What is a useful screening tool for people who you suspect may be experiencing depression
PHQ9
What is the treatment for a Mild–moderate depressive episode?
self-directed computerised CBT
https://www.justathought.co.nz/depression
structured group physical activity,
behavioural activation (doing more of what bring joy, meaning and purpose or a sense of mastery)
St John’s Wort, Omega 3
https://bluepages.anu.edu.au/index.php?id=lifestyle
Rongoa Maori
Brief counselling/talking therapy (focussed on resolving current issues)
Antidepressant medication for people with a past history of depression being effectively treated this way or
subthreshold symptoms persist despite trying other interventions
How do you treat moderate-severe depression?
Antidepressant medication in combination with talking therapy (Interpersonal Therapy IPT, Cognitive Behavioural
Therapy CBT, Acceptance and Commitment Therapy ACT)
In addition; physical activity,
Rongoa Maori, behavioural activation, Omega 3
ECT is sometimes used for treatment of severe depression. It is only considered when either a) nothing else has
worked or b) it has been a successful treatment in the past. For many whaiora this remains a controversial treatment
as a person may be under the Mental Health Act when it is administered and therefore experience it as being a
treatment being given against their will.
