TOPIC 4 - depressive disorders Flashcards
comorbidity and risk factors
prior history ox depression or family history
member of vulnerable groups
female
age 40 or under
active substance use
history of sexual abuse
postpartum period
stressful life events
history of other chronic mental or medical illness
DMDD is only diagnosed …
in childhood (before age 10)
percent of children less than 3 who have depression
15% (often under diagnosed and has a high recurrence rate)
percent of older adults with depression
20%
manifestations of depression
sadness, despair, empty, negative, pessimistic, anhedonia, anergia, avolition, low self esteem, apathy, social with-drawl, excessive emotional sensitivity, low frustration, irritable, insomnia, disrupted concentration, excessive guilt, indecisiveness
avolition
anhedonia
anergia
most common presentation of depressive symptoms in children
irritable (less likely to be sad or withdrawn)
assessing for depression
MSE
psychosocial assessment
physical assessment
standardized scales (Hamilton or SAD PERSONS)
assessing suicide risk
SADPERSONAS scale
SAFE-T
different types of suicidality
suicidal ideation, suicide attempt, completed suicide, parasuicidal behavior
monitoring and documentation guidelines for suicidal risk
1:1 continuous monitoring
document every 15 minutes (observations, statements, activities, behaviors)
biopsychosocial model
social / biological / psychological factors are all interlinked and important for regarding and promoting health
mind and body are not separate
biological factors
endocrine, immune, and neurosystem functioning
stress diathesis model
diathesis - predisposing cause or underlying vulnerability
stress - precipitating cause or triggering circumstance
= disorder
accounts for relationship between early life trauma and later development of vulnerability
cognitive theory triad
negative view of self + pessimistic view of world + belief that negative reinforcement will continue
people acquire a psychological disposition to depression from early life experiences
learned helplessness
condition of a human or animal that has learned to behave helplessly, failing to respond even though there are opportunities for help
(initial response to event is anxiety but then is replaced by depression- believed they are at fault)
depressive disorders
major depressive disorder
persistent depressive disorder
disruptive mood dysregulation disorder
major depressive disorder
depressed most of the day, most days of the week
significant distress or impairment in functioning due to symptoms
not attributable to substance use or other medical condition
persistent depressive disorder
chronic depression
less severe symptoms than in MDD
symptoms must have persisted for at least 2 years
able to function in life roles greater than those with MDD
DMDD (disruptive mood dysregulation disorder)
onset before age 10
s/s : severe temper outburst, inconsistent developmental level persistent irritability or anger
treatment: family supportive therapy, behavioral modification therapy, meds (stimulant, antidepressant, mood stabilizer)
therapy models
CBT, MBCT, ITP, bright light
MBCT
combination of CBT and mindfulness based stress reduction
