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15 Cards in this Set
- Front
- Back
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Burden of Depression
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1. Disability: second leading cause of disability in the world
2. Mortality: suicides, fatal accidents, self-neglect 3. Morbidity 4. Societal Costs 80 billion per year |
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Epidemiology of Depression
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12-18% lifetime prevalence
5-6% one year prevalence peak age 20-40 Women to men 2:1, decreases to 1:1 post menopause 2-3 greater risk with family history |
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Why do women experience more depression?
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dwell on feeling sad, men tend to deny or dismiss those thoughts or self medicate (addiction)
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Risk Factors for Depression
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Unmarried
Early losses Postpartum negative life events (highest risk) |
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Episode length
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15% last for years
most commonly 8-18 months |
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Recurrence rates
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1 episode: 50%
2 : 75% 3+: 95% |
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Theories of increased Depression rate?
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1. Greater recognition
2. Increase gene pooling 3. Greater gene expression of neuronal connections vulnerable to stress 4. Dietary changes (less omega 3) 5. Kindling Theory |
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What is the Kindling Theory?
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with each episode of depression more prone to have further depression with weaker stimuli or stressors
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5 possible outcomes during the 3 phases of Treatment of Depression
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1. Response
2. Remission 3. Relapse: decompensation after remission (during continuation) 4. Recovery 5. Recurrence: decompensation after recovery (during maintanence) |
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6 Potential courses of illness
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1. MDD, recurrent with full interepisode recovery
2. MDD, recurrent, without full interepisode recovery (most common) 3. MDD (chronic> 2 years) - 15% 4. Double Depression 5. Dysthymic Disorder 6. Persistent subthreshold depression |
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Amount receiving treatment
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50% get professional help, 35% see MD, 15% see Psychiatrist
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Depression Syndromes
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1. Vegetative Symptoms (Classic from DSM IV)
2. Cognitive Symptoms 3. Impulse control problems (agitation/ irritability) 4. Behavioral (common in adolescents) 5. Physical/Somatic (common in elderly and Asians) |
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Types of Somaticizers
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1. Initial Somaticizers
2. Facultative 3. Persistent |
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Reasons people have relapsed at 1 year
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1. Medicine noncompliance
2. Development of new life stressors 3. Loss of medication efficacy 4. Absence of psychotherapy |
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Structural Biology of Depression
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atrophy of:
1. Hippocampus 2. Amygdala 3. Prefrontal Cortex |
