Moses- Depressive Disorders Flashcards
Leading cause of disability and premature death in people aged 18 to 44 years.
Major Depressive Disorder
The prevalence of MDD is among patients with chronic medical illnesses.
30-50%
Up to of adults will have an episode of depression in their lifetime.
one-quarter
What are some factors that are related to depression?
- Gender
- Age
- Marital Status
- Mental Health Diagnosis
- Biological Factors
- Genetic Factors
- Psychosocial Factors
More severe major depressive illness occurs with those that begin with depression earlier/later in their lifetime?
earlier
What age group is at greatest risk for depression?
elderly
What are 5 high risk populations for depression?
- Postpartum Women
- Personal/Family History of MDD
- Advanced Age
- Neurologic Disorders
- Comorbid Systemic Physical Illness
What are the 6 main depressive orders in the DSM?
What is the timeline criteria for persistent depressive disorder (dysthrhymia)?
longevity of 2+ years
Which depressive disorder is characterized by an irritated and angry mood?
Disruptive Mood Dysregulation Disorder
What is the time criteria for PMDD?
symptoms 1 week before and after starting period. 2 weeks on and 2 weeks off
How many symptoms must be present, what is the timeline criteria, and what needs to be noted about baseline functioning for a diagnosis of MDD?
5+ criteria met
same 2 week period
change (decrease) in baseline functioning- KEY piece
Review the criteria for MDD
What is the acronym that lists the clinical features of MDD?
SIGECAPS
Screening tools are used to help with and
diagnosis and treatment
What is the most common screening tool for depression?
PHQ-9
What is the screening tool most commonly used for Post Partum depression?
Edinborough Depression Scale
List the scores for the following screening tool criteria to be met?
- Mild Depression: Score
- Moderate Depression: Score
- Moderately Severe Depression: Score
- Severe Depression: Score
- Greater than or equal to considered a positive screen.
- Mild Depression: Score 5-9
- Moderate Depression: Score 10-14
- Moderately Severe Depression: Score 15-19
- Severe Depression: Score 20-27
- Greater than or equal to 10 considered a positive screen.
There is/is not a huge overlap with major depression and medical illness?
is
Examples: endocrine/thyroid issues, cancer, sleep apnea, nutritional deficiencies
What are the 2 major classes of drugs most commonly used to treat MDD?
SSRIs
SSNRIs
Why is fluoxetine most commonly used if there is a risk for non-compliance?
longest half-life
What are some reasons to use and not use Mirtazipine?
And what populations does this medicine work well and not well
helps with sleeping and eating (great for elderly and weight gain)
not good for young adult females
Which antidepressant works well as an adjunct for the tx of resistant depression and as a tx for kids with ADD?
bupropion
What are some common side effects of antidepressants?
sexual dysfunction/ decreased libido, weight gain, sedation
What is the method of discontinuing use of antidepressants?
titrate down, do not stop cold turkey
Describe the treatment goal of MDD?
remisson of symptoms, titrate to the max dose possible that keeps symptoms under control
How long does it usually take to see benefit of antidepressant, and to see real changes?
up to 4 weeks for benefit
up to 3-6 mnths for real changes
What is the timeline criteria for maintenance of medications?
stay on board for 4, 9, even 12 mnths after the remission of symptoms
(because of risk of relapse w/in first 6 mnths)
What are 2 non pharmacological first line treatments that can be used for mild depression?
- Interpersonal Psychotherapy
- Cognitive Behavioral Therapy
Which non pharmacological tx are mainly used for tx resistant depression?
- Transcranial Magnetic Stimulation (TMS)
- Electroconvulsive Therapy (ECT)
