Flashcards in depressive disorders Deck (20):
Major depression diagnosis
five or more of the following nine have to be present for 2 weeks and represent a change in normal functioning. at least one has to be depressed mood or loss of interest or pleasure.
what are the nine symptoms.
1. depressed mood most of the day. 2. markedly diminished interest or pleasure in all or most activities most of the day. 3. significant weight loss or gain more than 5%. 4. insomnia or hypersomnia nearly everyday. 5. psychomotor agitation or retardation that must be observable by others. 6. fatigue or loss of energy. 7. feelings of worthlessness or excessive inappropriate guilt. 8. diminished ability to think or concentrate. 9. recurrent thoughts of death.
what is the nemonic for diagnosis of depression. stands for?
suicide, interest, guilt, energy loss, concentration/agitation, appetite, psychomotor, sleep disturbances.
what is another nemonic
suicide, weight loss/gain, anhedonia, guilt.
seasonal affective disorder
MDD associated with the changing seasons mostly shorter days in the winter. usually has atypical symptoms.
how to treat SAD
full spectrum light exposure, psychotherapy and antidepressants
depressed patients presenting with vague symptoms but are unaware or in denial of their illnesses. seem stoic.
who is more likely to be seen with masked depression?
elderly patients who have either OCD or narcissistic personality
what is monoamine theory of MDD
decreased levels of the monoamines DA, NE, 5HT. could have more receptors (excess theory). loss of neurotropic factors and degeneration theory as well.
stress and cortisol theory
that increased stress produces higher levels of cortisol (glucocorticoids) which decrease the amount of brain-derived neurotropic factor within the brain. this causes atrophy or death of neurons. (should this be modified to say synapses?)
who has a higher lifetime prevalence for depression?
what are the comorbidities for depression?
substance abuse and generalized anxiety
what are the front line treatments for MDD
SSRI, SNRI, NDRI
second line therapy
MAOi and TCA
mosre depressed in AM, better in PM. this is melancholic.
cognitive symptoms in depressed elderly pften misdiagnosed as dementia.
more likely to have weight gain and hypersomnia. also has leaden paralysis, carb cravings and rejection sensitivity.
what happens if a patient takes cortisol pills of autoimmune disorder?
they can get depressed because of BDNF>
does depression get better or worse?
depression usually begets depression. `