MDD and bipolar I Flashcards
What are the top two conditions that PCPs see?
- HTN
2. Depression
What fraction of adults have depression?
1/10
What is dysthymia?
a mood disorder consisting of the same cognitive and physical problems as in depression, with less severe but longer-lasting symptoms
1st degree relatives of depressive patients are how many times more likely to have depression?
1.5-3x more likely
True or false: first degree relatives of those with depression have an increased risk of alcohol use
True
Children of individuals with MDD have an increased risk of what other diseases?
Anxiety
AD(H)D
What are the labs that are diagnostic for depression?
There are none
What is the pathophysiology of depression?
- Dysregulation of several neurotransmitter systems
- Dysregulation of cerebral blood flow
True or false: all patients with depression have some sort of identifiable pathophysiology causing their depression
False
What are the diagnostic criteria for depression? (9)
- depressed mood
- Anhedonia
- Change in appetite or weight
- change in sleeping habits
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthlessness or guilt
- Diminished ability to concentrate
- Recurrent thoughts of death
(FC GRAMPAS)
How long do s/sx of MDD have to last to be considered MDD? How many s/sx are needed?
For at least 2 weeks, 5+ symptoms, at least one of which is loss of interest/pleasure in ALL things
Women are how many times more likely to have a depressive episode as compared to men?
2x
True or false: the increased risk for depression in women is true for young girls compared to boys
False
What is the average age of onset for depression?
mid 20s
True or false: unlike anxiety disorders, MDD tends to be episodic
True
True or false: most of the time, depression is self limiting
True
What percent of individuals who meet criteria for MDD still meet the criteria a year later?
40%
What percent of individuals who have an episode of MDD never have another?
40%
True or false: usually the first/second episode of MDD is preceded by a psychosocial stressor
True
What is the dysthymia that occurs with depression?
Loss of interest in most things, not just one thing
How can you differentiate grief from depression?
Grief is largely transient, variable, and has a cause, while depression is a pervasive mood disruption that does not vary
True or false: it is not uncommon to have some psychotic s/sx with grief reactions
True
What is adjustment disorder with depressed mood?
Persistent depression 2/2 significant life change
What is the right way to view depression in patients who are well off?
Risk factors
What is dysthymia (Persistent depressive disorder)?
Chronic, low grade depression over 2 years time that may not meet full criteria for MDD
What are two things that should be r/o with all MDD, but especially those who are hospitalized?
- Mood disorder 2/2 general medical condition
- Substance-induced mood disorder
What should always be asked prior to asking about mood?
Mental status
What are the five diagnostic modifiers with depression?
- mild
- moderate
- severe
- part remission
- full remission
What are the mixed features modifier of MDD?
Criteria are met for both a depressive episode and a manic episode simultaneously for at least a week
What is disruptive mood dysregulation disorder?
a psychiatric disorder, characterized by persistently irritable or angry mood with recurrent, severe temper outbursts
Can you have manic s/sx and still have MDD?
No
What is unspecified depressive disorder?
Had a clinically significant depressive event, but not enough to meet criteria
What should always be r/o with MDD s/sx?
Substance abuse
What should always be assessed for prior to dispensing antidepressants?
Bipolar disorder
What is the strongest indicator for predicting recurrence of depression?
Residual symptoms
