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14 Cards in this Set
- Front
- Back
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Who are most likely to have depressive episode?
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Women, during reproductive years. Increased incidence after you've already had a depressive episode.
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What is the #1 risk for depression
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SUICIDE! ALWAYS CHECK FOR THIS FIRST. HIGHEST PRIORITY!!
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What are personal, permanent, pervasive versus impersonal, transient, specific?
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P, P, P is depressive personality disorder. Internal misprocessing of stressors. I, T, S are more optimistic ways of handling stress.
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What is depressive personality disorder?
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Traits: Personal (they themselves are the root of the problem), Permanent (happens everytime), Pervasive (this ruins other aspects of their lives)
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Common pathway of depression?
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Dysregulation of prefrontal cortex hypoactivity
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What are the diagnostic criteria for depression?
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Suicidal thoughts, insomnia, lack of energy/interest, feelings of guilt/worthlessness, anhydonia
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Diagnostic criteria for MDE (major depressive episode)
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Marked social/occupational impairment. Not related to medical (hypothyroidism) or substance abuse. NOT MIXED EPISODE. THERE ARE SUBTYPES
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What are the mood disorders?
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Dysthymic, bipolar I, bipolar II, MDE, cyclothymic.
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Goals of antidepressant treatment?
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Acute (6-12 wks) = lower suicide risk, remission of depressive symptoms
Continuation (4-5 months) = adherence, setting goals, education. ACUTE/CONTINUATION ARE HUGE FOR EACH EPISODE. Maintenance (>1 yr) = Optimize adherence, restore psych. fxn |
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Treatment options for depression
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SSRI = selective serotonin reuptake inhibitor (first-line)... can deal with anxiety as well
SNRI = serotonin nori reuptake inhibitors NDRI = nori dopamine reuptake inhibitors SARI = serotonin antagonism and reuptake inhibition NASSA = alpha-2 antagonist and serotonin antagonist MAOI = monoamine oxidase inhibitor TCA = tricyclics |
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How long do you keep treating for depression?
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First episode = ~12 mths
Second episode = maintenance treatment Third episode = lifelong treatment TAPER OFF...SAME DRUG DOSE ACUTE AS CONTINUATION |
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How is depression presented?
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SOMATICALLY!! Especially in elderly. ~20% consults are primarily psychiatric
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ALGORHYTHM of Depression treatment
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Monotherapy (NOT TCA), then monotherapy (TCA ok), combination therapy (meds + psychotherapy), Somatic (VNS, ECT...)
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Where is brain stimulated for treatment of depression?
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PRIMARILY IN LEFT PREFRONTAL CORTEX!!!
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