Prevention of Depression Flashcards
What are the criteria for a major depressive disorder
key symptoms (need at least one or both of these)
- Depressive mood (feeling ‘down’)
- Loss of interest
Other symptoms
- Weight gain or loss
- Insomnia or hypersomnia
- Psychomotor agitation or reduction
- Tiredness / loss of energy
- Feelings of worthlessness
- Reduced concentration
- Recurring thoughts about death
What are the differences between the major depression, minor depression, dysthymia, and bipolar disorder
Major depression: at least 2 weeks, at least 5 symptoms
Minor depression: at least 2 weeks, 2-4 symptoms
Dysthymia: at least 2 years, at least 2 symptoms
Bipolar disorder: also manic episodes
What are the prevalence and prognosis of depression?
- Twice as high in women
- Decrease w/ age (cohort, society, age)
- High relapse: 50% after two years
- Not all patients seek treatment (60-80%)
- Almost half has comorbid anxiety disorder (46%)
- Almost half incident cases (47%)
What are the symptoms of depression in babies and infants?
Anaclitic depression: crying, seeking, protest, despair, withdrawal, apathy
Infant: frequent crying, failure to thrive, sleep and eating disturbances, slower growth
What are the different theories about depression?
Biological theories: genetics, dysregulation of neurotransmitters, brain deviations, hormonal factors
Psychological theories: behavior theory, cognitive theory, psychodynamic theory, interpersonal theory
Stress-vulnerability model
What are treatments for depression?
- biological treatment: antidepressants, ECT, light therapy
- Other treatments: acupuncture, exercise
- Psychological treatments: Cognitive behavior therapy, interpersonal psychotherapy, behavioral activation
Why is it important to focus on prevention of depression?
- High prevalence
- High incidence
- Huge burden of disease
- Highest burden of disease in 2030 in developed countries
- Treatments can reduce burden of disease with not more than 35%
- Huge economic costs
Limited possibilities of treatment
What are some interventions to prevent depression?
Self-help book Coping with depression course * Cognitive restructuring * Behavioral activation * Social skills 6 week telephone calls * No therapy, only support in working through materials * Max 15 minutes
Explain another intervention called stepped-care
Four steps:
- Watchful waiting
- Guided self-help (coping with depression and anxiety)
- Brief psychotherapy (PST)
- Referral to GP for medication
Step take each 3 months, screening every three months
What is the use of web-based guided self-help when it comes to depressive disorders?
?
What is the coping with depressions course?
Cognitive behavior therapy, existing of:
- psycho-education, not psychotherapy
- toolbox idea
Four components
- Relaxation
- Cognitive skills
- Social skills
- Pleasant events
What is the social learning theory?
Depression is learned, spiral of negative interaction between a person and environment
Insufficient reinforcement
Negative and positive spiral of mood
How to adapt the coping with depression?
analysing problems of target group
retain basic elements:
- activity scheduling
- cognitive restructuring
- social skills
adapting to needs of population
Standardise
what are the limitations of cwd?
Not appropriate for all depressed persons
Understanding of own problems and behavior
To be able to function in group
Not effective in all participants
Processes are not well understood
Which criteria should a person meet in order for prevention intervention to be offered?
- People are judged to be at risk of developing major depression in near future?
- The population-level health gains are as large as possible
- The costs of offering the interventions are as low as possible
- Preventive interventions are likely to be as efficient as possible
