Flashcards in Depression Deck (52)
mean age of onset
equal out with older age over 55yrs
urban vs rural
types of depressive episode
mil or moderate +/- somatic syndrome
severe +/- pyschotic symptoms
ICD 10 criteria for dx depression
1. low mood most days most of the time for >2wks
2. loss of interest in activities previously found enjoyable
3. low energy
1. loss of confidence, low self esteem
2. inappropriate guilt
3. thoughts of death or suicide
4. poor concentration/indecisive
5. psychomotor change
6. poor appetite
7. sleep problems
what is mild depression
2 major + 2 minor criteria
what is moderate depression?
2 major + 4 minor criteria
what is a severe depressive episode?
3 major + five minor criteria
somatic always present
what is somatic syndrome in unipolar depression
four + of the below:
2. lack of reaction to enjoyable events
3. early morning waking
4. depressed mood with diurnal variation
5. psychomotor change
6. appetite loss, wt loss
7. loss of libido
causes of depression
2. structural brain changes
genetics of depression
relatives: 9.1% risk
MZ concordance 40-50%
serotonin transporter gene
Structural brain changes in depression
reduced volume in hippocampus and caudate nuclei
blood flow in brain in depression
1. prefrontal cortex
2. anterior cingulate gyrus
4. basal ganglia
what is the monoamine theory?
depression due to probs with serotonin, dopamine and NA levels in brain
evidence for serotonin theory?
1. decreased tryptophan (serotonin precursor) foundin depressed patients
2. tryptophan low diet - depression like syndrome
3. antidepressants work on serotonin
4. low serotonin and precursors in autopsy depressed patients
5. platelet serotonin binding is decreased in depression§
evidence for NA involvement depression?
1. depression in people who are given NA depleting agents
evidence for dopamine involvement
1. in animals antidepressants increase dopamine
2. dopamine metabolites low in depressed patients
where is dopamine increased with antidepressants?
aside from monoamines/genetics - biological causes of depression?
1. endocrine - HPA axis -50% with cushings are depressed + 50% depressed are non suppressed on dexa test
2. thyroid - 25% depressed patients have blunted TSH response to TRH
Aside from biological causes - causes of depression?
social theories depression?
1. brown + harris
3. life events
brown + harris?
increased depression in women who:
1. >3 kids under age of 14
2. no confiding relationships
3. not working outside home
marriage + depression?
life events and depression?
6x increase in life events 6 months before depressive episode - loss events. Threat events = anxiety
psychological theories of depression?
psychodynamic theories of depression?
freud, bowlby + klein
link w/ loss + interpersonal problems in childhood
cognitive theories of depression?
Beck (developer of CBT) says latent dysfunctional assumptions learned through early experiences activate events which lead to cycle of negative thinking and depressed mood
seligman theory depression