2. Mood Disorders - Depression

Front 1

What is the leading cause of years lived with disability in the world?

Back 1

Unipolar Major Depression

Front 2

What % of patients with major depression commit suicide?

Back 2

10-15%

Front 3

What % of patients with schizophrenia commit suicide?

Back 3

10-13%

Front 4

What is unipolar major depression projected to become by the year 2020?

Back 4

The leading cause of disease burden in females and developing countries!

Front 5

What is the paradigm in how the healthcare system handles affective disorders?

Back 5

-Low recognition rate
-Highly treatable
-Comparable amount of dollars spent on it with other highly recognized but NONtreatable chronic illnesses

Front 6

What is the most common psychiatric symptom?

Back 6

Depression

Front 7

What is the annual prevalence rate of
-Major depression
-Dysthymic disorder

Back 7

MD = 5%

Dysthymia = 5.4%

Front 8

In a given year how many people will be depressed?
-With major depression
-With bipolar depression

Back 8

11 million people total
-5 million major depression
-1.8 million bipolar

Front 9

What does the functional impairment from depression exceed?

Back 9

Pretty much everything
-Diabetes/HTN
-Arthritis/back problems
-Gastrointestinal problems

Front 10

What are 4 things you'll see in the presentation of depression?

Back 10

SASC (sassy)
-Somatic complaints
-Anxiety
-Sleep disturbance
-Cultural influences

Front 11

What has the best treatment efficacy; major depression, atherectomy, or angioplasty?

Back 11

Major depression!

Front 12

How much depression is:
-Diagnosed and treated?
-Diagnosed and untreated?
-Undiagnosed?

Back 12

25/25/50

Front 13

What somatic symptoms have the highest PPV for depression?

Back 13

-Sleep disturbance
-Fatigue
-Nonspecific pain
-Back pain
-SOB

Front 14

What 3 medical illnesses have the highest prevalence of depression?

Back 14

-Diabetes
-Stroke
-Cancer

Front 15

What is
-Reactive depression
-Endogenous depression

Back 15

Reactive: to a circumstance
Endogenous: idiopathic

Front 16

What is
-Psychotic depression
-Neurotic depression

Back 16

Psychotic - out of touch w/ reality
Neurotic - related to some conflict

Front 17

What is
-Primary depression
-Secondary depression

Back 17

Primary - depression in itself
Secondary - due to something else, ie htn medications

Front 18

What is
-Bipolar depression
-Unipolar depression

Back 18

Bipolar - swinging between manic and depressed
Unipolar - constant depression

Front 19

What is
-Agitated depression
-Retarded depression

Back 19

Agitated = you see observable agitation
Retarted - it's like they're in slow motion

Front 20

What are the 2 main classes of Mood Disorders?

Back 20

1. Bipolar disorders
2. Depressive disorders

Front 21

What are the 2 main subtypes of Depressive disorders?

Back 21

1. Major depressive disorder
2. Dysthymic disorder

Front 22

What are 2 ways that major depressive disorder can present?

Back 22

-Single episode
-Recurrent

Front 23

So how will patients with depression often present?

Back 23

With symptoms of insomnia, fatigue, weight loss, and unexplained somatic complaints.

Front 24

What is the First Step in investigating depression?

Back 24

Rule out other medical conditions, substance use, or mental disorders.

Front 25

What is the time frame for considering major depression?

Back 25

Symptoms persist over a 2 week period.

Front 26

What types of depression would you consider if the symptoms DID persist over a 2 week period?

Back 26

-Single episode major depr disrd
-Recurrent major depr disorder

Front 27

What would you consider if there was ALSO a history of elevated, expansive, or euphoric mood?

Back 27

Bipolar I or II disorder

Front 28

What would you suspect if the depressed mood was present for most of the past 2 YEARS?

Back 28

Dysthymic disorder

Front 29

How long in children to diagnose dysthymic disorder?

Back 29

1 yr

Front 30

What would you consider if the depressed mood was associated with the death of a loved one and persists for less than 2 months?

Back 30

Bereavement

Front 31

If a depressed mood occurs in a patient in response to an identifiable psychosocial stressor, and does not meet the other criteria, what would you consider?

Back 31

-Adjustment disorder w/ Depressed mood
-Adjustment disorder with mixed anxiety and depressed mood

Front 32

What do you call it if depression is clinically significant, but criteria are not met for any of the previously described disorders?

Back 32

DEPRESSIVE DISORDER NOT OTHERWISE SPECIFIED.

Front 33

What are the diagnostic criteria for Major Depressive Episode?

Back 33

At least 5 symptoms for at least 2 weeks

Front 34

What are 2 symptoms that the patient has to have at least one of to call it major depressive episode?

Back 34

-Depressed mood
-Loss of interest/pleasure

Front 35

What are 7 symptoms the patient has to have at least 4 of?

Back 35

-Weight change
-Sleep change
-Movement change
-Energy loss
-Worthlessness/guilt
-Decreased concentration
-Death thoughts

Front 36

What CAN'T be seen during the 2 weeks to be able to call it Major Depressive Episode?

Back 36

-Mixed episode (bipolar)
-Significant distress/impairment
-substance abuse
-general medical conditions
-bereavement

Front 37

What is a helpful acronym for diagnosing depression episodes?

Back 37

SIGECAPS

Front 38

What is SIGECAPS?

Back 38

-Sleep disorder
-Interest deficit
-Guilt
-Energy deficit
-Concentration deficit
-Appetite disorder
-Psychomotor retard/agitated
-Suicidality

Front 39

And how many of these do you have to see in the same 2 wk period?

Back 39

5/more

Front 40

What is a brain change that is thought to be associated with depression?

Back 40

Hippocampal shrinkage

Front 41

What is a MAJOR risk in people with major depression?

Back 41

Suicide

Front 42

Acronym for assessing suicidal risk:

Back 42

IS PATH WARM

Front 43

What is often construed as depression but it is not?

Back 43

Bereavement