Prevention of depression Flashcards
What are the DSM criteria to confirm to major depressive disorder? How does it look across the ages?
At least:
- Depressive mood
- loss of interest
And at least 3 of the following:
- weight gain/loss
- insomnia/hypersomnia
- psychomotoric agitation/reduction
- tiredness / loss of energy
- feeling of worthlessness
- reduced concentration
- recurring thoughts about death.
These are valid for all ages. Symptom patterns and the context (family) might differ.
What are the differences between major depression, minor depression, dysthymia, and bipolar disorder when looking at the required symptoms?
Major depression: at least 2 weeks and at least 5 symptoms
Minor depression: at least 2 weeks and 2-4 symptoms
Dysthymia: at least 2 years, at least 2 symptoms
Bipolar disorder: also manic episodes.
What are symptoms of depression in babies? And in infants?
Anaclitic depression:
- crying
- seeking
- protest
- despair
- withdrawal
- apathy
Infant depression
- frequent crying
- failure to thrive
- sleep and eating disturbances
- slower growth
What are biological theories about depression?
- genetics
- dysregulation of neurotransmitters
- brain deviations
- hormonal factors
What are psychological theories about depression?
- Behaviour theory
- cognitive theory
- psychodynamic theory
- interpersonal theory
Combined with biological theory: stress-vulnerability model.
What are biological, psychological, and other treatments for depression?
Biological:
- antidepressants
- ECT
- light therapy
Psychological
- CBT
- interpersonal psychotherapy
- behavioural activation
Other:
- acapuncture
- exercise
Explain the intervention spectrum for mental disorders.
Half a wheel with pie pieces that belong to over arching treatments.
Prevention:
* universal, selective, indicated
Treatment
- case identification
- standard treatment
Maintenance
- long term treatment
- after-care
Why is prevention of depression important?
- Because the high prevalance and incidence
- High burden of disease
- Treatment can’t reduce burden of disease enough (now 15 max 35%)
- limited possibilities of treatment
- huge economic costs
Explain the “coping with depression” course. Name basic elements, used concepts, effectiveness, and limitations.
Indicated prevention, compared to care as usual
It is a CBT with the basic elements
- psycho-education
- toolbox idea
It is psychological prevention program with CBT concepts:
o Cognitive restructuring
o Behavioural activations
o Social skills
o Guided by 6 weekly telephone calls to support working through the materials (no therapy)
(Cost) effective.
Limitations
o Not appropriate for all depressed persons
o Understanding of own problems and behaviour
o To be able to function in group
o Not effective in all participants
o Processes are not well understood
Name a preventive intervention of depression in older adults. Name the steps included and the type of prevention.
Stepped care. Indicated prevention.
Including four steps:
o Watchful waiting
o Guided self-help (coping with depression and anxiety)
o Brief psychotherapy (PST)
o Referral to GP for medication
o Every step was for three months, and screening was done every three months
Effective with lower incidence.
Explain web based guided self help and the type of prevention.
- for patients with subthreshold depression
- indicated prevention
- Guided web-based prevention (PST and behavioural activation)
- Compared to care as usual
- Effective, incidence was lowered.
