Depression & Chronic Diseases Flashcards
(18 cards)
What is Major Depressive Disorder?
A mood disorder characterized by symptoms such as sad/depressed mood or loss of interest in daily activities for at least 2 weeks
Other symptoms include changes in weight, sleep, appetite, psychomotor activity, concentration, feelings of worthlessness, excessive guilt, and suicidality.
What are the symptoms required for a diagnosis of Major Depressive Disorder?
Symptoms must include:
* Sad/depressed mood OR loss of interest or pleasure in daily activities
* Other somatic symptoms (e.g., changes in weight, sleep, appetite)
* Other cognitive symptoms (e.g., difficulty concentrating, feelings of worthlessness, excessive guilt)
* Suicidality
Symptoms must represent a significant change from regular mood for more than 2 weeks and cause impairments in functioning.
How is Major Depressive Disorder diagnosed?
Through a clinical interview with a psychologist or healthcare professional, ruling out other causes like medical conditions and substance use
Depression is often identified and treated in primary care settings.
What is the prevalence of Major Depressive Disorder in chronic disease?
About 5-7% in any given year.
Lifetime prevalence is higher
Depression is common among people with chronic diseases and is predicted to be the leading cause of disability worldwide by 2030.
What are the Whooley Questions used for?
To screen for depression in primary care
Questions assess if individuals have felt down/depressed or lost interest in activities over the past month.
True or False: Routine depression screening is always recommended in primary care.
False
In the U.S., screening is useful only if there are adequate systems for treatment; Canada usually does not recommend it unless symptoms are present.
What are some effects of depression on health behaviours in patients with heart disease?
Depressed individuals exhibit:
* Less physical activity
* Poor medical adherence
* Higher likelihood of obesity
* Worsened sleep
* Increased smoking
These effects were observed 5 years later in patients with heart disease.
What is HIV?
A virus that attacks the immune system, specifically targeting CD4 cells
It spreads through blood, semen, vaginal and anal fluids, and from mother to baby.
What is the significance of a CD4 count in HIV patients?
A healthy CD4 count is around 500; if untreated, HIV can progress to AIDS with a count below 200
AIDS can also be diagnosed by contracting opportunistic diseases.
What was the UN goal for HIV awareness and treatment by 2020?
90% of people should be aware of their HIV status, on treatment, and engaged in viral load suppression
This goal was not met, and rates of HIV have increased in Canada.
What are the benefits of ART adherence?
Benefits include:
* Sustained viral suppression
* Reduced risk of drug resistance
* Better overall health
* Improved quality of life
* Decreased risk of HIV transmission
Adherence is crucial for maintaining health and reducing transmission risk.
What percentage of adherence is needed to suppress the HIV virus?
95% adherence is needed
Adherence challenges include substance use, unstable housing, and complex medication regimens.
What types of treatments are available for depression in HIV patients?
Treatments include:
* Antidepressants
* Cognitive-behavioural therapy (CBT)
* Other psychosocial interventions (e.g., mindfulness-based stress reduction, support groups)
CBT is noted as particularly effective.
Does depression treatment improve ART adherence?
Yes, a meta-analysis showed 83% better odds of ART adherence with depression treatment
This highlights the importance of addressing mental health in HIV care.
What is the relationship between depression and cardiovascular disease?
Depression prevalence is higher among patients with cardiovascular disease, particularly in heart failure
Depression influences biological factors that increase cardiovascular risk.
How is depression treated among patients with cardiovascular disease?
Treatments include:
* Self-management strategies
* Psychotherapy
* Antidepressant medications
Treatment depends on the individual’s level of functioning and preferences.
What was the outcome of the study comparing exercise and antidepressants for treating depression in heart disease patients?
Both exercise and antidepressants were effective in improving depression symptoms compared to a placebo
Exercise also improved aerobic fitness more than medications.
What is the summary of the findings regarding depression and chronic conditions?
Depression is prevalent, serious, and treatable; it predicts poorer medication adherence in HIV/AIDS and heart disease patients and has bidirectional associations with inflammation and health behaviours
Treatment benefits extend to patients with both depression and chronic conditions.
