Depression

Question 1

The lifetime risk for major depressive disorder is:

Answer 1

7 to 12 percent for men and 20 to 25 percent for women.

Question 2

Approximately what percent of patients in primary care settings have significant depressive symptoms?

Answer 2

10-40%

Question 3

___ of depressed patients present to their doctors only with somatic complaints.

Answer 3

70%

Question 4

he two key psychic symptoms of depression are:

Answer 4

depressed mood and loss of

interest (anhedonia) in normal activities.

Question 5

What is loss of interest in normal activities called?

Answer 5

anhedonia

Question 6

Do people with depression always FEEL depressed?

Answer 6

people with depression may not feel depressed, will deny being depressed, and feel numb and disconnected instead.

Question 7

What is the suicide rate in depression?

Answer 7

The suicide rate in depression is ~15%.

Question 8

asking what two questions about mood & anhedonia may be as effective as longer
questionnaires?

Answer 8

“Over the past two weeks (or ever), have you felt down, depressed, or hopeless?”
and
“Over the past two weeks (or ever), have you felt little interest or pleasure in doing things?

Question 9

What life event increases the risk of developing depression later in life?

Answer 9

an early loss

Question 10

The ___-___-____ axis is hyperactive in depression. What are the effect of this?

Answer 10

The hypothalamic-pituitary-adrenal axis is hyperactive in depression which can lead to
endothelial inflammation and excessive clotting due to excessive cortisol secretion
and hippocampal cell death.

Question 11

Chronic depression leads to morphological changes in the brain, including _____
cell death and pruning of specific neurons in the brain due to prolonged _____ and ↓ ______
(BNDF).

Answer 11

hippocampal

prolonged stress,
brain-derived neurotrophic factor

Question 12

Is it normal for the bereaved to hallucinate briefly the person who died.

Answer 12

yes, briefly

Question 13

People with what genetic variant are more susceptible to developing depression after stressful life events?

Answer 13

People with one or two copies of the short allele promoter variant of the serotonin
transporter gene versus those people homozygous for the long allele variant.

Question 14

Patients with depression and what other condition have a higher prevalence of an associate panic disorder? What is unique about their treatment response?

Answer 14

sub-clinical hypothyroidism

The have a poorer response to antidepressant drugs than euthyroid
depressed patients.

Question 15

The “Baby Blues” exists in all cultures, symptoms peak within_______of delivery &
consist of:

Answer 15

3-5 days

tearfulness, mood lability, irritability and rejection hypersensitivity, and resolve
within 24-72 hours.

Question 16

___of women with a history of bipolar mood disorder or previous postpartum depression
will develop post-partum depression.

Answer 16

50%

Question 17

What types of therapy have the most empirical support for
depression at this time thought there is also evidence for the use of dynamic psychotherapy as well? Cognitive treatment addresses cognitive distortions such as negative thinking & catastrophizing.

Answer 17

Cognitive behavioral and interpersonal therapies

Question 18

Chemically, anti-depressants affect______ systems.

Answer 18

monoamine

Question 19

Prescribing antidepressants to patients who might be bipolar – without first being on a ___ ____ such as lithium - runs the risk of precipitating what?

Answer 19

mood stabilizer

hypo-manic or manic episode.

Question 20

Depressed patients are ___ times more likely to die in the 6 months post MI than non- depressed patients

Answer 20

3-4x

Question 21

depressed patients have _ times the risk of death post CABG than non-depressed patients

Answer 21

2

Question 22

Decreasedheart-rate variability due to sympathetic activity override of parasympathetic influences via the vagus nerve, increases the risk of what?.

Answer 22

ventricular arrhythmias and sudden death

Question 23

Comment of depression and taking treatment as scheduled

Answer 23

Depression makes it harder for patients to adhere to medical advice & treatment

Question 24

Depression (and anxiety disorders) can adversely affect heart rhythms, increase blood
pressure, alter blood clotting, lead to elevated insulin and cholesterol levels, and to
chronically elevated levels of cortisol and norepinephrine.

Answer 24

.

Question 25

Is there evidence that treating depressed patients post-MI with selective serotonin re-uptake inhibitors reduces subsequent morbidity and mortality?

Answer 25

there is some evidence that treating depressed patients post-MI with selective serotonin re-uptake inhibitors reduces subsequent morbidity and mortality

Question 26

There is a likely a _______ relationship between depression and cerebrovascular disease. High rates of depression are found in patients with cerebrovascular disease & depression may occur as a result of vascular disease in a significant sub-population of the elderly.

Answer 26

bi-directional

Question 27

What medical conditions occur disproportionately within bipolar disorder patient populations?

Answer 27

hypertension, hyper-lipidemia, and hepatitis C.

Question 28

What are the most proven effective psychotherapies at this time?

Answer 28

Cognitive behavioral and interpersonal therapies.

Question 29

Patients with schizophrenia have ~ a __% reduced life expectancy compared with the general population and are _____ times more likely to commit suicide.

Answer 29

20 10-20

Question 30

More than ____ of patients with schizophrenia, compared with approximately ___ in the general population, die of coronary heart disease.

Answer 30

2/3 1/2