What are the 9 symptoms of major depressive disorder?
SIG E CAPS
- Sleep disturbance
- Interests gone
- Energy loss
- Appetite changes
- Pscyhomotor retardation
- Suicidal Ideations
What timing characterizes a major depressive episode?
What symptoms are needed to meet the criteria?
Episodes are defined as at least 2 weeks of symptoms, usually lasting 6-12 months. It may be self-limited, it may not.
5 of the 9 SIG E CAPS symptoms are needed in addition to depressed mood.
What timeline is seen in persistant depressive disorder?
How do the symptoms compare to major depressive disorder?
Symptoms last at least 2 years, but are often milder than in major depressive disorder.
What is seasonal affective disorder?
What treatment is typically effective?
symptoms of depression associated with the winter season.
full-spectrum bright light exposure
Sleep changes in depression:
- Slow-wave sleep?
- REM latency?
- REM early in the sleep cycle?
- Total REM?
- Nighttime awakenings?
- Early morning awakenings?
- Decreased Slow-wave sleep
- Decreased REM latency
- Increased REM early in the sleep cycle
- Increased Total REM
- Multiple Nighttime awakenings
- Increased Early morning awakenings
How many patients with depression are diagnosed?
How many patients diagnosed with depression are treated?
Only half of patients with depression are diagnosed
Only half of diagnosed patients are treated
What should be considered in patients with a chronic medical illness?
Depression! (what a shocking answer!)
About 25-50% of patients dealing with diabetes, cancer or stroke also have major depressive disorder.
What two questions are an effective screen for major depressive disorder?
In the past two weeks, have you felt down or hopeless?
In the past two weeks, have you felt little interest in doing things?
What is the PHQ-9?
How is it scored?
Patient Health Questionairre-9
9 symptoms ranging form not at all to nearly every day
What PHQ-9 scores translate into diagnoses?
- 5-9 mild symptoms=> educate, but follow-up
- 10-14 minor depression => psychotherapy or pharmaceuticals
- 15-19 moderately sever major depression => pscyhotherapy or pharmaceuticals
- 20+ severe major depression => pyschotherapy & pharmaceuticals
What is the menomic for suicide risk?
IS PATH WARM
What are the three stages of bereavement?
Preoccupation with the deceased
What are some non-pharmaceutical treatments for depression?
St John's Wort
Electro convulsive therapy
Vagal nerve stimulation
Transcranial magnetic stimulation
Deep brain stimulation
What are the 5 outcomes of treatment for depression?
- Response- improvement of symptoms occuring within 6-12 of treatment
- Relapse- return of symptoms 4-9 months after beginning of treatment
- Remission- no return symptoms 4-9 months after beginning treatment
- Recurrence- return of symptoms 1 year after beginning treatment
- Recovery- no return of symptoms 1 year after beginning treatment