Treatment for depression

Question 1

The General Risk Factor that leads to suicide in the General population

Answer 1

A poor, elderly, lonely, man, with physical/mental comorbidities and previous attempts

Question 2

Main Concept that explains Pathophysiology of Depression

Answer 2

Monoamine Hypothesis:

- Decreased Neurotransmitters in the Brain: NE, 5HT, DA

Question 3

What are some Medical Disorders that are common secondary causes for depression

Answer 3

1. Endocrine disorders (E.g. Hypothyroidism, Cushing)
2. CVD: CAD, CHF, MI
3. Others: Deficiency states, infection, emtabolic disorders, malignancy, neurological

Question 4

Acronym for Clinical Presentation and what do each letter stands for?

Answer 4

IN SAD CAGES

• INterest: Decreased
• Sleep: Insomnia/Hypersomnia
• Appetite: Decreased, and weight loss
• Depressed: sometimes irritable in children
• Concentration: Impaired
• Activity: Psychomotor retardation/agitation
• Guilt
• Energy: decreased, or fatigue
• Suicidal thoughts/attempts

Question 5

DSM-5 Diagnostic Criteria for Major Depressive Disorders (MDD)

Answer 5

1. At least FIVE sx present in same 2-week period

2. ONE of the sx MUST be “depressed mood” or “loss of interest”

Question 6

Describe how sx of MDD affects patients

Answer 6

1. Causes significant distress or impairment in social/occupational orother important areas of functioning
2. Sx NOT caused by underlying medical condition or substance (E.g. alcohol)
   - Must ALWAYS rule out when dx MDD

Question 7

Non-pharmacologicals for depression:

Answer 7

• Improve sleep hygiene
• Psychotherapy: usually in combination with antidepressants
• Neurostimulation
• Electroconvulsive treatment
• repetitive transcranial magnetic stimulation