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MD4001 Pathology > depression > Flashcards

Flashcards in depression Deck (18):
1

what is an affective disorder

a mood disorder

2

what is dysthymia

persistant mild depression

3

what are the main types of affective disorder

dysthymia
major depression
bipolar disorder

4

what are the 7 As of depression

Anhedonia
appetite loss
anergia
AM waking
amenorrhoea
asexual
affective disorder

also: agitation, poor concentration, indecisiveness, exessive guilt, inability to perform ADL

5

what do the letters in the mnemonic DESPAIR stand for

depressed mood or disinterest
energy loss/ tired all the time
sleep disturbed
pessimism, hopelessness
appetite/weight changes
impaired concentration
retardation/ agitation
suicidal ideation/ reccurent thoughts

in addition: emotional, cognitive, behavioural symptoms

6

what are some features of major depression

most symptoms present, which markedly intefere with functioning
can occur with or without psychotic symptoms

a diagnosis should take into account the degree of functional impairment and duration of episode

7

what are the cognitive symptoms of depression

lowered self esteem and self confidence
guilt and worthlessness
feelings of hopelessness and helplesness
pessimistic and reccurrently negative thoughts about oneself, past, present and future
poor concentration
reduced attention
difficulty making decisions
rumination

8

what somatic/ behavioural symptoms of depression are there

appetite change
insomnia
early morning wakening
loss of libido
social withdrawal

9

what questions can you ask to elicit talking about symptoms of depression

• During the last month, have you often been
bothered by feeling down, depressed or
hopeless?
• During the last month, have you often been
bothered by having little interest or pleasure in
doing things?

10

what factors can increase the risk of depression

genetic
early life experience
previous mental health
stressful life events
gender (more common in women)
chronic or serious disease
substance abuse
lack of supportive relationships
lack of employment
many children

11

what stressful life events could precipitate an episode of reactive depression

– Failure at work, at school, loss of a job;
– Marital separation;
– Rejection by a loved one;
– Death of a child;
– Illness of a family member;
– Physical illness

12

what factors may contribute to a higher rate of depression in women

– Women may express and report symptoms more than
men
– Hormones
– Early life stress: e.g., sexual abuse (girls are more
likely to be sexually abused)
– Additional stresses such as responsibilities both at
home and work, single parenthood, caring for children
and aging parent, higher emotional burden

13

how does physical health conditions and depression interact

physical conditions may increase the chance of depression and depression may worsen the distress associated with physical illness, including adversely affecting outcomes and shortening life expectancy

depression can be a risk factor for illnesses such as cardiovascular disease (it is an independant predictor or mortality and morbidity)

14

why is assessment of depression difficult in chronically ill patients

many signs of depression may also be a symptom of physical disease
drug treatment may cause depression as a side effect

15

how can depression affect coronary heart disease

less likely to adhere to medication, life style interventions, rehab programmes

depression is a risk factor for smoking, diabetes, lower exercise tolerance

may trigger dysregulation of neurohormonal systems responsible for cortisol and catecholamine production

16

discuss the link between depression and diabetes

prevalence is twice as high among diabetics

more severe symptoms, poor glycaemic control, more complications, more health care use

17

what psychological treatments are available for depression

CBT
interpersonal therapy
problem solving skills
behavioural activation therapy
psychodynamic psychotherapy

CBT has best evidence base

18

what factors can contribute to suicide

Health system
Health care access, access to means to
suicide, media reporting
• Stigma against seeking help for suicidal
beh/mental health issues/substance abuse

community/relationships:
War/disaster;
• discrimination; isolation; abuse/violence

individual factors:
Previous suicide attempts
• Mental disorders
• Harmful use of alcohol
• Financial loss
• Chronic pain
• Family hx of suicide