Module 5.1: Depression

Question 1

What are the diagnosis criteria used for a diagnosis of major depressive disorder?

Answer 1

diagnosis is made on the basis of the existence of a collection of signs and symptoms. In Australia , we use the DSM-IV (APA 1994) (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.)

The DSM-IV criteria:
* depressed mood or loss of interest/pleasure in daily activities for more than 2wks

• Mood represents a change from person’s baseline
• Impaired function: social, occupational, educational
• Specific symptoms (at least 5 of 9) present nearly every day.

Question 2

List the 9 specific signs & symptoms of depression

Answer 2

1) Depressed mood or irritable (observed by others)
2) Decreased interest or pleasure (in most activities)
3) Significant weight change (5%) or change in appetite
4) Change in sleep patterns (Insomnia / hypersomnia)
5) Change in activity (psychomotor agitation/retardation
6) Fatigue or loss of energy
7) Guilt/worthlessness (feelings of)
8) Concentration (impaired)
9) Suicidal ideation

Question 3

List 5 Biological causes of depression

Answer 3

• Genetic vulnerability
• Biochemistry
• Serotonin / noradrenaline (low levels)
• Birth trauma
• Physical illness

Question 4

List 4 Psychological causes of depression

Answer 4

• Link to personality
• past experiences
• Loss
• Methods of coping

Question 5

List 4 Social causes of depression

Answer 5

• Gender
• Employment
• Housing / financial problems
• Substance abuse/misuse

Question 6

List 7 links between depression and physical illness

Answer 6

1) Pain: Effect on perception & tolerance of pain
2) Loss & Grief: Common reaction to stressful/distressing situation
3) Prescription medication: may lead to the development of depressive symptoms
4) Alcohol / illicit (+non) drugs: Assess for possible cause/complication factor
5) Cognitive impairment: Poor recall & impaired concentration
6) Self-perception: Belief system adversely influences perception of self
7) Coping mechanisms: Reflective day to day stressors

Question 7

list 3 methods of treatment for depression

Answer 7

1) Psychopharmacological (TCAs, SSRIs, SNRIs, MAOIs)
2) Psychological therapies
3) Electro-convulsive therapy (ECT)