Depression Flashcards Preview

Psych > Depression > Flashcards

Flashcards in Depression Deck (52)
Loading flashcards...
1

prevalence

10-20% lifetime
12month 2-5%

2

mean age of onset

27

3

gender distribution

M:F 1:2
equal out with older age over 55yrs

4

urban vs rural

more urban

5

types of depressive episode

mil or moderate +/- somatic syndrome
severe +/- pyschotic symptoms

6

ICD 10 criteria for dx depression

Major:
1. low mood most days most of the time for >2wks
2. loss of interest in activities previously found enjoyable
3. low energy

Minor:
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

7

what is mild depression

2 major + 2 minor criteria

8

what is moderate depression?

2 major + 4 minor criteria

9

what is a severe depressive episode?

3 major + five minor criteria
somatic always present
+/- psychosis

10

what is somatic syndrome in unipolar depression

four + of the below:
1. anhedonia
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

11

causes of depression

1. genetics
2. structural brain changes

12

genetics of depression

relatives: 9.1% risk
MZ concordance 40-50%
serotonin transporter gene

13

Structural brain changes in depression

reduced volume in hippocampus and caudate nuclei

14

blood flow in brain in depression

altered in
1. prefrontal cortex
2. anterior cingulate gyrus
3. amygdala
4. basal ganglia

15

what is the monoamine theory?

depression due to probs with serotonin, dopamine and NA levels in brain

16

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§

17

evidence for NA involvement depression?

1. depression in people who are given NA depleting agents

18

evidence for dopamine involvement

1. in animals antidepressants increase dopamine
2. dopamine metabolites low in depressed patients

19

where is dopamine increased with antidepressants?

nucleus accumbens

20

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

21

Aside from biological causes - causes of depression?

1. social
2. psychological

22

social theories depression?

1. brown + harris
2. marriage
3. life events

23

brown + harris?

increased depression in women who:
1. >3 kids under age of 14
2. no confiding relationships
3. not working outside home

24

marriage + depression?

lower rates

25

life events and depression?

6x increase in life events 6 months before depressive episode - loss events. Threat events = anxiety

26

psychological theories of depression?

1. psychodynamic
2. cognitive
3. seligman

27

psychodynamic theories of depression?

freud, bowlby + klein
link w/ loss + interpersonal problems in childhood

28

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

29

seligman theory depression

learned helplessness

30

treatment for depression is guided by?

NICE guidelines for stepped care