Depression Flashcards
1
Q
What is the definition of depression?
A
ICD-10: constellation of symptoms for longer than 2 weeks, with lowering of mood, reduction of energy and decrease of activity
2
Q
How common is depression?
A
Very common, especially in females and older people
3
Q
What is the pathophysiology of depression?
A
- Mild, moderate or severe
- Altered levels of CRH (stress hormone regulator)
- ↓ in levels of serotonin, norepinephrine or dopamine
4
Q
What are the risk factors/aetiology of depression?
A
- Female
- Past history of depression
- Family history of depression
- Traumatic events in life – especially in childhood
- Significant physical illness causing disability/pain
- Other mental health problems
- African-caribbean/Asian/redugee/asylum seeker communities
- Hypothyroidism
- Drugs: centrally acting antihypertensives, lipid soluble bet blockers, benzodiazepines, progesterone contraceptives
5
Q
What are the signs/symptoms of depression?
A
- Biological
- Persistent sadness/low mood nearly everyday
- Loss of interest/pleasure in most activities
- Fatigue/loss of energy
- Psychomotor agitation/retardation
- Insomnia/hypersomnia
- Psychological
- Worthlessness
- Excessive/inappropriate guilt
- Recurrent suicidal thoughts/suicidal attempts
- Lack of concentration
- Increased indecisiveness
- Somatic
- Changes in appetite/weight
- Constipation
- Amenorrhoea
- Loss of libido
6
Q
What diseases present similarly to depression?
A
- Bipolar disorder
- Psychosis
- Dementia
- Seasonal affective disorder
- Bereavement
7
Q
What investigations are carried out to diagnose depression?
A
- Patient Health Questionnaire (PHQ-9)
- Geriatric depression scale
- Hospital Anxiety and Depression Scale
- Mental state examination
- Speaking to family members
- Blood glucose, U&Es, LFTs, TFTs, Ca, FBC, inflammatory markers
- MRI/CT
8
Q
What are the surgical treatments for depression?
A
• Electroconvulsive therapy
9
Q
What are the pharmacological treatments for depression?
A
Antidepressants - SSRI normally first line
10
Q
What are the non pharmacological treatments for depression?
A
- CBT – therapy or computerised
- Relaxation therapy
- Brief psychological therapies
