1.1 What is depression?

Question 1

Waar gaat het artikel van WHO over?

WHO (2017)

Answer 1

• Wat depressie is
• De 2 categorieen van depressie
• General information
• Prevalence
• Suicide

Question 2

Depressive disorders are defined by:

WHO (2017)

7

Answer 2

1. Loss of interest
2. Feeling low
3. Insomnia/hypersomnia
4. Increased/decreased appetite
5. Lack of focus
6. Feelings of worthlessness and guilt
7. Lack of energy

–> Lead to impairments at school, work/daily life; long-lasting or repetitive; might lead to suicide

Question 3

What are 2 main categories of depression?

WHO (2017)

Answer 3

1. Major depressive disorder (MDD)
2. Dysthemia

Question 4

MDD

WHO (2017)

3 symptomen

Answer 4

1. Diminished interest
2. Low mood
3. Reduced energy levels

Classified as mild, moderate or severe

Question 5

Dysthemia

WHO (2017)

Answer 5

Chronic depression

Long lasting symptoms and mild version of depressive episode

Question 6

Depression is one of the two main common mental disorders, which are:

WHO (2017)

Answer 6

1. Depression
2. Anxiety

Question 7

How many people are impacted by depression?

WHO (2017)

Answer 7

More than 300 million (4.4% of world population)

Question 8

Prevalence

WHO (2017)

4

Answer 8

1. More in women
2. Less in older age or for children under 15 years
3. Prevalences have varying intensity levels
4. Frequent in low and middle income countries

Question 9

Suicide and depression

WHO (2017)

3

Answer 9

1. Responsible for 1.5% of death around the world
2. Very common in ages between 15-29
3. Suicide frequently fluctuated depending on sex, region and income level.

Question 10

Waar gaat artikel van Hermann over?

Hermann et al. 2022

Answer 10

• What is depression (symptoms and diagnosis)
• Complicated/uncomplicated depression
• Descriptors
• Characteristics
• Functioning affected by depression
• Depression literacy
• Conclusion

(Ook wel over culturele verschillen)

Question 11

What is depression?

Hermann et al. 2022

Answer 11

Condition with clinically identifiable symptoms and observed behaviours related to distress and disturbance of personal functions (ICD-11)

Question 12

Wat is verschil tussen ICD and DSM in depression?

Hermann et al. 2022

Answer 12

Symptom in ICD but not in DSM:

‘Hopelessness about the future’

=very strong indicator to differentiate people with and without depression.

Question 13

Number of symptoms required for diagnosis

Hermann et al. 2022

Answer 13

5

This discriminates against cases that have less than 5 symptoms, but do have depression –> subthreshold depression.

Question 14

Differentiate depression from regular sadness

Hermann et al. 2022

Answer 14

These could be used to address subthreshold depression:
1. Minimum 1 main depressive symptom: loss of pleasure or depressed mood, at least 2 weeks
2. Presence of any 2 depressive symptoms, for at least 2 weeks, with indication of social impairment

Question 15

Patients Health Questionnaire (PHQ-9)

Hermann et al. 2022

Answer 15

Assesses severity of depression:
- commonly used
- Self-report
- Scored on 4-point likert scale
- Assesses 9 symptoms

Question 16

Complicated vs uncomplicated depression

Hermann et al. 2022

Answer 16

This helps to determine the severity of depression.

Complicated= min 1 symptom of following:
- Suicidal ideation
- Feelings of wothlessness/guilt
- Psychotic symptoms
- Functional impairment

Question 17

Descriptors

Hermann et al. 2022

Answer 17

Help diagnose depression instead of seperate diagnostic categories.
- Psychotic features
- Melancholia
- Atypical features

Question 18

Characteristics depression

Hermann et al. 2022

Answer 18

• More common women
• Bias in ICD –> because majority of research is done in English speaking countries
• Comorbidity: substance, anxiety = common
• Physical comorbidity: diabetes, cognitive impairment, chronic pain, cardiovascular diabetes etc.
• Majority of suicidal death is due to depression
• Some have recurrent episodes, other have only one

Question 19

Areas of functioning affected by depression

Hermann et al. 2022

5

Answer 19

1. Early discontinuation of studies
2. Decreased earning/income
3. MDD males were more likely to get involved in intimate partner violence
4. Depression in parents have adverse effect on children (anxiety, substance, physical health)
5. Looking after people with depression is isolating –> bigger chance of depression yourselve

Question 20

Protective factors

Hermann et al. 2022

Answer 20

1. Social support
2. Personality characteristics
3. Interest

= resilience towards depression

Question 21

Risk factors depression

Hermann et al. 2022

Answer 21

1. Forced migration

Nog wel meer, maar deze staat nu als enige genoemd.

Question 22

What leads to deficiency in seeking help, not following treatment regularly and suicidal ideation?

Hermann et al. 2022

Answer 22

Pessimistic views toward depression and discrimination

Question 23

Depression literacy

Hermann et al. 2022

Answer 23

Comprehending strategies to achieve and maintain positive mental health, also understanding depression and its treatments.
- Might help to determine whether individual seek help or not
- Social interaction is very effective to improve depression literacy.

Question 24

Conclusion Hermann

Hermann et al. 2022

Answer 24

1. Many countries lack resources to deal with challenges of depression.
2. There are not enough skilled providers and mental health care systems are not funded enough.

Question 25

Waar gaat artikel Maj et al. over? | Maj et al. (2020)

Answer 25

- What is depression - Verschil ICD en DSM - 3 classes of depressive symptoms - **Subtypes depression** - Severity depression - Personality traits

Question 26

What are 9 symptoms for depression diagnosis (ICD and DSM) | Maj et al. (2020)

Answer 26

1. Low mood 2. Decreased interest/pleasure 3. Lack of focus/indecisiveness 4. Feelings of guilt/worthelessness 5. Suicidal ideation 6. Difference in appetite/weight 7. Functional impairment 8. Insomnia/hypersomnia 9. Energy loss/tiredness "Hopelessness about future" = ICD-11

Question 27

What are extra indicators for depression? | Maj et al. (2020) ## Footnote 4

Answer 27

These are effective to distinguish between people with and without depression: 1. Irritability 2. Anxiety 3. Somatic symptoms (tension muscles, headaches) 4. Lack of reaction to positive stimuli

Question 28

3 classes of depression | Maj et al. (2020) ## Footnote Has no empirical support

Answer 28

1. Cognitive Behavioural 2. Neurophysiological 3. Affective

Question 29

Different symptoms according to sex: symptoms males: | Maj et al. (2020)

Answer 29

1. More aggression 2. Risk taking 3. Irritability

Question 30

2 main clinical subtypes of depression | Maj et al. (2020)

Answer 30

1. Melancholic (autonomous) 2. Non-melancholic (situational)

Question 31

Melancholia | Maj et al. (2020)

Answer 31

Lack of pleasure and movement related activity.

Question 32

Symptoms melancholia | Maj et al. (2020)

Answer 32

Sowieso 2 symptoms: 1. Lack of reaction to positive stimuli 2. Loss of pleasure in almost all activities In combination with **at least 3** of following: 1. Depression worse in **morning** 2. Low mood 3. Decreased **movement** related activity 4. Waking up **very early** in the morning 5. Excessive guilt 6. Significant weight loss/anorexia

Question 33

# Subtypes Psychotic depression | Maj et al. (2020)

Answer 33

Hallucinations/delusions are present throughout depressive episode, psychotic **not** present outside depressive episode. - In recurrent episodes: some episodes psychotic, some not. All episodes could be psychotic. --> Also: increased risk **suicide** + increased risk **biological causes**

Question 34

# Subtypes Mixed depression | Maj et al. (2020)

Answer 34

Min 3 manic symptoms should be present: 1. Elevated mood 2. Talking more 3. Increase self-esteem (grandiosity) 4. Increased energy 5. Racing thoughts 6. Not needing much sleep 7. Increased risk taking (This type is not included in ICD-11)

Question 35

# Subtypes Anxious depression | Maj et al. (2020)

Answer 35

Min 2 symptoms should be present: 1. Feeling strained (gespannen) 2. Anxious more than usual 3. Fear of somethin bad happening 4. Lack of focus due to worry 5. Feeling of losing control over self --> Also: increased likelihood suicidal ideation, poor performance and poor life quality, more likely to be chronic.

Question 36

# Subtypes Seasonal depression | Maj et al. (2020)

Answer 36

Depends on patterns of depressive episodes throughout one's life. During: spring/summer or autumn/winter Symptoms: 1. Excessive eating 2. Craving carbohydrates 3. Hypersomnia

Question 37

DSM classification of severity | Maj et al. (2020)

Answer 37

- **Mild**: not many more symptoms than necessary for diagnosis. Symptoms are manageable, functioning in social/work slightly negative. - **Moderate**: is not defined, apart from the mention of its presence between mild and severe. - **Severe**: more symptoms than necessary for diagnosis, unmanageable and affect social/work severely

Question 38

ICD classification of severity | Maj et al. (2020)

Answer 38

- **Mild**: intense symptoms are absent, challenges in education/work/social/family/performance. - **Moderate**: symptoms more intense than mild, more challenge in performance - **Severe**: most symptoms present, some very intense, nearly completely unable to perform in different areas

Question 39

# Personality traits depression Five Factor Model (FFM) | Maj et al. (2020)

Answer 39

1. Extraversion/introversion 2. Openness to experience/unconcentionality 3. Agreeableness/antagonism 4. Neuroticism 5. Conscientiousness/disinhibition

Question 40

Which of FFM makes people more prone to negativity/depression/anxiety? | Maj et al. (2020)

Answer 40

Neuroticism Causes people ot interpret neutral situations negatively, react negatively to stress and be overwhelmed in reaction to small problems.

Question 41

Cognitive triad | Maj et al. (2020)

Answer 41

People with depression have a negative view of the **world, themselves and their future**.