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3.4C Affective Disorders > 1.1 What is depression? > Flashcards

1.1 What is depression? Flashcards

1
Q

Waar gaat het artikel van WHO over?

WHO (2017)

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

Depressive disorders are defined by:

WHO (2017)

7

A
  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

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3
Q

What are 2 main categories of depression?

WHO (2017)

A
  1. Major depressive disorder (MDD)
  2. Dysthemia
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4
Q

MDD

WHO (2017)

3 symptomen

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

Classified as mild, moderate or severe

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5
Q

Dysthemia

WHO (2017)

A

Chronic depression

Long lasting symptoms and mild version of depressive episode

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6
Q

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

WHO (2017)

A
  1. Depression
  2. Anxiety
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7
Q

How many people are impacted by depression?

WHO (2017)

A

More than 300 million (4.4% of world population)

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8
Q

Prevalence

WHO (2017)

4

A
  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
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9
Q

Suicide and depression

WHO (2017)

3

A
  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.
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10
Q

Waar gaat artikel van Hermann over?

Hermann et al. 2022

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

(Ook wel over culturele verschillen)

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11
Q

What is depression?

Hermann et al. 2022

A

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

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12
Q

Wat is verschil tussen ICD and DSM in depression?

Hermann et al. 2022

A

Symptom in ICD but not in DSM:

‘Hopelessness about the future’

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

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13
Q

Number of symptoms required for diagnosis

Hermann et al. 2022

A

5

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

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14
Q

Differentiate depression from regular sadness

Hermann et al. 2022

A

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

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15
Q

Patients Health Questionnaire (PHQ-9)

Hermann et al. 2022

A

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

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16
Q

Complicated vs uncomplicated depression

Hermann et al. 2022

A

This helps to determine the severity of depression.

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

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17
Q

Descriptors

Hermann et al. 2022

A

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

18
Q

Characteristics depression

Hermann et al. 2022

A
  • 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
19
Q

Areas of functioning affected by depression

Hermann et al. 2022

5

A
  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
20
Q

Protective factors

Hermann et al. 2022

A
  1. Social support
  2. Personality characteristics
  3. Interest

= resilience towards depression

21
Q

Risk factors depression

Hermann et al. 2022

A
  1. Forced migration

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

22
Q

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

Hermann et al. 2022

A

Pessimistic views toward depression and discrimination

23
Q

Depression literacy

Hermann et al. 2022

A

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.

24
Q

Conclusion Hermann

Hermann et al. 2022

A
  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.
25
Q

Waar gaat artikel Maj et al. over?

Maj et al. (2020)

A
  • What is depression
  • Verschil ICD en DSM
  • 3 classes of depressive symptoms
  • Subtypes depression
  • Severity depression
  • Personality traits
26
Q

What are 9 symptoms for depression diagnosis (ICD and DSM)

Maj et al. (2020)

A
  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

27
Q

What are extra indicators for depression?

Maj et al. (2020)

4

A

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

28
Q

3 classes of depression

Maj et al. (2020)

Has no empirical support

A
  1. Cognitive Behavioural
  2. Neurophysiological
  3. Affective
29
Q

Different symptoms according to sex: symptoms males:

Maj et al. (2020)

A
  1. More aggression
  2. Risk taking
  3. Irritability
30
Q

2 main clinical subtypes of depression

Maj et al. (2020)

A
  1. Melancholic (autonomous)
  2. Non-melancholic (situational)
31
Q

Melancholia

Maj et al. (2020)

A

Lack of pleasure and movement related activity.

32
Q

Symptoms melancholia

Maj et al. (2020)

A

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

33
Q

Subtypes

Psychotic depression

Maj et al. (2020)

A

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

34
Q

Subtypes

Mixed depression

Maj et al. (2020)

A

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)

35
Q

Subtypes

Anxious depression

Maj et al. (2020)

A

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.

36
Q

Subtypes

Seasonal depression

Maj et al. (2020)

A

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

37
Q

DSM classification of severity

Maj et al. (2020)

A
  • 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
38
Q

ICD classification of severity

Maj et al. (2020)

A
  • 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
39
Q

Personality traits depression

Five Factor Model (FFM)

Maj et al. (2020)

A
  1. Extraversion/introversion
  2. Openness to experience/unconcentionality
  3. Agreeableness/antagonism
  4. Neuroticism
  5. Conscientiousness/disinhibition
40
Q

Which of FFM makes people more prone to negativity/depression/anxiety?

Maj et al. (2020)

A

Neuroticism

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

41
Q

Cognitive triad

Maj et al. (2020)

A

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

3.4C Affective Disorders (16 decks)

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