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31 Cards in this Set
- Front
- Back
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What are the two essential features of depression, which you must have at least one of? (DSM-IV TR)
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1) Depressed Mood
2) Markedly diminished pleasure in all or most activities. |
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What are the 7 extra features, which you must have at least three of, to diagnose depression?
(DSM-IVTR) |
1) Significant weight loss when not dieting.
2) Insomnia or hypersomnia. 3) Psychomotor agitation or retardation. 4) Fatigue or loss of energy. 5) Feelings of worthlessness or excessive or inappropriate guilt. 6) Diminished ability to think or concentrate, or indecisiveness. 7) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation, suicidal plan |
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What is the overall criteria?
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Five or more of the symptoms (must include either 1 or 2), present on most days, for most of the day, over at least 2 weeks, associated with distress and impairment of functioning.
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What is anhedonia?
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Little or no capacity for the experience of pleasure. It is one of the core features of depressive disorders.
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What are the core elements of depressive disorders (i.e. not just depression).
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1. A mood state best described as emptiness.
2. Anhedonia. 3. Restricted reactivity in mood. 4. Negative thought content. 5. Poor self-esteem. 6. Significant disruption of sleep. 7. Amotivation. 8. Anergia. 9. Hopelessness and helplessness. |
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What is the DSM-IVTR for melancholic depression?
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Meets criteria for major depressive episode or severe depression.
Marked psychomotor disorder, retardation or agitation. Loss of pleasure in all activities, including libido. Lack of reactivity to pleasurable stimuli. Distinct quality of depressed mood, different to grief. Depression much worse in mornings. Early morning awakening (at least 2 hours earlier than usual). Severe anorexia and/or weight loss. Excessive or inappropriate guilt. |
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What changes in thinking occur during depression?
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Depressive disorders have an effect upon thought content. Often provoked by persistently negative and self-defeating patterns of thought.
Excessive guilt about real or imagined wrongdoings. Suicidal thoughts. Capacity to think may be impaired: concentration, memory, comprehension. Executive cognitive functions may be affected: decision making, abstract thinking, problem solving. |
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What is psychomotor retardation?
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Severe impairment of thought function and physical spontaneity.
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What changes in biological function can occur during depression?
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Sleep disruption:
- difficulty initiating sleep. - terminal insomnia - waking several hours earlier than usual Reduced appetite and weight loss. Energy impairment. Reduced motivation. Reduced libido. |
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What changes in self-care occur during depression?
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The loss of motivation extends to grooming, personal hygiene and dress.
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What changes in social-interaction occur as a result of depression?
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Social isolation, which further aggravates the illness.
Might be embarassed to be in company because of depressed mood and lack of spontaneity. Might be unmotivated to see others. |
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What is psychotic depression?
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In some instances the depressed person can become psychotic, lose touch with reality and be at serious risk of self-harm or neglect.
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What sorts of delusions might be evident in psychotic depression?
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They might think that bad world events are there fault (inappropriate guilt). They might picture terrible things happening to their bodies (e.g. inside decay).
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What sorts of hallucinations might be evident in psychotic depression?
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Hallucinations - auditory. For example, a second person or third person voice saying negative things about them.
Hallucinatinos - olfactory. Dead smell, e.g. due to decay. |
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What are some of the features of atypical depression?
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mood remains reactive to events
high sensitivity of rejection 'leaden' feeling in limbs hypersomnia hyperphagia |
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What is premenstrual dysmorphic disorder?
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Depressive symptoms that occur immediately before the onset of menses (up to 2 weeks before hand). Irritability, abdominal discomfort, even suicidal thoughts.
SSRIs can help. |
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What is grief and how is it different to depression?
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Grief is a normal response. It is in response to a loss. Delusions, hallucinations, illusions can occur but this may be comforting, not distressing. It is usually self-limited.
If it continues onwards it is called pathological-grief and can transition into depression. |
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What is an adjustment disorder?
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Distressing reactions to unpleasant life events that do not meet the criteria for depressed disorder.
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What are the stages of grief?
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Denial
Anger Bargaining Depression Acceptance |
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What general medical disorders can be related to depression?
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Stroke.
hypothyroidism. hypomagnesium. Cushing's syndrome. Addison's. Dementia. Deliurm. Hypocalcemia. vitamin D deficient. Vitamin B deficient. Corticosteroid use. Intracerebral neoplasia. Autoimmune cerebral vasculitis. Acquired brain injury. |
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What are the main actions of serotonin?
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Modulating mood, aggression, sleep, appetite.
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What is the role of noradrenalin?
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Drive, focus of thought, mood, appetite.
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What is the role of dopamine?
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Thought, pleasure, sex, psychomotor function.
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How long do you need to have depression before you can be classified as MDD in DSM-IV-TR?
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One month.
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What are vegetative symptoms of depression?
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anorexia
early morning wakening and others |
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What is the lifetime prevalence of depression?
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15 - 20%
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DSM-IV TR for depression?
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At least ONE of the following for at least TWO weeks:
- persistent depressed and mood - loss of interest and pleasure At least four of the following: - weight loss or gain - insomnia or decreased sleep - agitation or retardation - fatigue or loss of energy - feelings of worthlessness or inapproriate guilt - diminished inability to concentrate or indecisiveness - thoughts of death or suicide |
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causes of organic mood disorder - depression
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steroids
alcohol amphetamines (the crash after the high) cancer hypothyroidism B12/folate |
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what is dysthymia
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more chronic
often due to poor early life experiences, e.g. bullying, poor relationship to parents grumpy, annoying, self-defeating |
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what is most common first option for depression
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sertraline 50 - 150mg mane
escitalopram 10 - 20mg mane |
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what are some features of hypomania
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increased goal direction
appetitive pursuits motoric - hyperactivity, insomnia, wired, energised, speech pressure expansiveness elevation ideational - grandiosity, pressure of thought |
