Depression (10 & 11)

Question 1

What are the DSM criteria for depression?

Answer 1

1- Depressed Mood
2- Diminished interest
3- Significant changes in weight
4- Insomnia or hypersomnia
5- Psychomotor agitation or retardation
6- Fatigue or loss of energy
7- Feelings or worthlessness or inappropriate guilt
8- Diminished ability to think or concentrate/ indecicive
9- Recurrent thoughts of death/ suicidal ideation

Question 2

How many symptoms must be present and for how long, in order to Dx depression?

Answer 2

5 or more (out of the 9) symptoms

Present during the same 2-week period

Question 3

T/F: at least one of the symptoms of depression is either depressed mood or loss of interest

Answer 3

True

Question 4

What is used to determine if a person has “normal” sadness or is depressed?

Answer 4

Need to have at least 1 or the following:

1- suicidality
2- Weight loss
3- Anhedonia
4- Guilt

Question 5

Define atypical depression:

Answer 5

More likely to have weight gain and hypersomnia

Can also lead to leaden paralysis, carb craving, rejection sensitivity

Question 6

What is psuedodementia?

Answer 6

cognitive symptoms in depressed elderly that are often misdiagnosed as “dementia”

Question 7

What is diurnal variation?

Answer 7

More depressed in AM and better in the PM

Question 8

What are psychomotor symptoms?

Answer 8

Physical complaints such as body aches and headaches

Question 9

What is seasonal affective disorder (SAD)?

Answer 9

Usually associated with the shorter days of winter

Usually associated with atypical symptoms

Question 10

How is SAD treated?

Answer 10

Full spectrum light exposure

Psychotherapy

Antidepressants

Question 11

Explain masked depression?

Answer 11

Depressed patients presenting with vague physical ailments but unaware/ in denial of their depression

seem stoic

Question 12

What are some possible medical causes of depressive symptoms?

Answer 12

Hypothyroidism

Cushing’s Syndrome

Anemia

Brain injury/ strokes

Vitamin deficiency (B12, Folate, Vit D)

OSA

Question 13

Name 4 biological factors that can may lead to depression?

Answer 13

1- Monoamine deficiency (decreased DA, SR, NE)

2- Monoamine Receptor Excess

3- Loss of neurotrophic factors and degeneration

4- Genetic variation in serotonin transporter gene

Question 14

Explain the receptor excess theory?

Answer 14

Increase transmitter and decrease receptor can lead to reversal of symptoms

Question 15

After 4 depressive episodes…how do low genetic risk brains compare to high genetic risk brains?

Answer 15

They look the same

Question 16

What is the stress- cortisl depression theory?

Answer 16

Stress increases glucocorticoids which decreases neurotrophic factors that leads to atrophy/ death of neurons

Question 17

What is seen in a depressed brain upon imaging?

Answer 17

Hypoactive DLPFC and a hyperactive amygdala

Question 18

T/F: Men outnumber women with depression

Answer 18

False…but women might seek help more often that can lead to this statistic

Question 19

What are the Front line agents for depression?

Answer 19

SSRI, SNRI, NDRI

Question 20

What are some older pharmacological treatments for depression?

Answer 20

MAOI, Triycic antidepressants (TCA), Sedating antidepressants, and Augmenting strategies (Lithium, thyroid hormone, atypical antipsychotic)

Question 21

What Rx are used last for depression?

Answer 21

MAOI and TCA

Question 22

Name some faster acting treatments for depression?

Answer 22

IV psychostimulants (ketamine)

Electroconvulsive therapy (ECT)–> shock treatment

Question 23

Name 4 neurostimulation techniques:

Answer 23

Vagus Nerve Stimulation (VNS)

Transcranial Magnetic Stimulation (TMS)

Deep Brain Stimulation (DBS)

Transcranial Direct Current Stimulation (TDCS)

Question 24

What is the fastest/ most effective method to get undepressed?

Answer 24

ECT shock treatment

Question 25

What are some psychological treatments for depression?

Answer 25

Talk therapy, Cognitive/ Behavioral Therapy