Depressive DIsorders

Question 1

Depressive Disorderes

DM 5 list (shortened)

Answer 1

• Major Depressive Disorder (MDD)
• Persistent Depressive DIsorder
• Pre-Menstrual Dysmorphic Disorder
• Disruptive Mood Dysregulation Disorder
• Substance/Med-induced

Question 2

Depression vs Sadness

Answer 2

Depression = less/unresponsive to positive environmental stimuli

Question 3

MDD

Dx

Answer 3

5+ s/s for MINIMUM 2 WEEKS (change from previous functioning)

• Depressed mood
• Loss of interest to activities
• Weight change
• Insomnia/hypersomnia
• Psychomotor agitation/retardation
• Energy loss
• Less concentration
• Guilt/worthlessness
• Death/suicide thoughts

Depression Is Worth Studiously Memorizing Extremely Grueling Criteria, Sorry.

Question 4

MDD

DSM specifiers

• anxiety
• mixed features
• melancholic features

Answer 4

• anxiety
• min 2 s/s
• mixed features = manic-like, but not timeline for bipolar, can develop to bipolar
• melancholic features = pleasure loss, worse in morning

Question 5

2ndary depression

• drug
• metabolic
• Neuro
• Pancreatic cancer

Answer 5

• drug = opioid
• metabolic = hypothyroidism
• Neuro = Parkinson’s, tumor, stroke
• Pancreatic cancer = interleukins

Question 6

MDD

MC comorbidities

Answer 6

Anxiety disorder
Substance Use
Personality Disorder

Also: med condition, environ stress, dysthmia (double depression)

Question 7

MDD

Endocrine bases

Answer 7

Cortisol not shutting down when chronically flooding brain

Question 8

MDD

Striatum

Answer 8

sluggish movement

Question 9

MDD

Neocortex

Answer 9

Concentration

Question 10

MDD

Amygdaloid Body

Answer 10

Anxiety

Question 11

MDD

Hypothalamus

Answer 11

Sleep Appetite

Question 12

MDD

Hippocampus

Answer 12

Memory problems

Question 13

Best chance of full remission w/ patients who

Answer 13

pursue Tx

Question 14

ADDs good for actute/longterm Tx?

Answer 14

long-term

Question 15

Suicide

Investigate:

Answer 15

• Plan?
• Plan lethality?
• Access to means?
• Intent?
• Oppose/Accept plan?
• Social Support?
• 24/7 Observation?
• Comorbidity?

Question 16

MDD

Who?

Answer 16

Female
White
Old
Widow

Question 17

MDD

Treatment

Answer 17

Mild/Moderate = ADDs

Severe = ADD + Psychotherapy

Refractory = Transcranial Magnetic Stimulation (TMS), Electroconvulsive Therapy (ECT)

Question 18

ADD treats ____ s/s

Answer 18

Psych (1st ) + Somatic s/s

Question 19

MDD

Thought distortion

Answer 19

Give too much value to unrealistic thought

Question 20

Depressed mood + 2 other depressive s/s FOR 2 YEARS+

• +/- periods of major depression (double depression)
• NO if d/t substance/med

Answer 20

Persistent Depressive Disorder (Dysthymia)

Dx

Question 21

Severe temper outbursts w/ underlying persistent angry mood

• 3+ outbursts/week
• Irritable mood + outbursts AT LEAST 1 YEAR
• Before 10 y/o (NO dx after 18 y/o)
• NO w/ ODD

Answer 21

Disruptive Mood Dysregulation Disorder (DMDD)

Dx

Question 22

DMDD

Who?

Answer 22

males

Question 23

DMDD

Tx

Answer 23

Cognitive behavioral Therapy (children)

Question 24

MDD

Exclude for Bereavement/Grief?

Answer 24

NO

depression s/s LESS than 2 months after death of loved one

Question 25

``` 5 s/s + at least one (*) MIN 2 cycles ***Affective Lability*** ***Irritability*** ***Depressed mood*** ***Anxiety/ Tension*** *decreased interest *Poor concentration *Fatigue *appetite change *hypersomnia/insomnia *overwhelmed *breast/joint tenderness, weight gain ```

Answer 25

Premenstrual Dysphoric Disorder

Question 26

Mania = s/s MIN 1 WEEK Hypomania = s/s MIN 4 days NO d/t RX 3+ s/s: * grandiosity * Less sleep need * Pressured speech * DIstractability * UP activity, agitation * Consequential Behavior * NO d/t Rx

Answer 26

Mania/Hypomania Dx

Question 27

MUST HAVE: * lost of pleasure * inability to respond to pleasurable stimuli +3 * Depressed mood * worse in morning (diurnal variation) * Terminal insomnia * psychomotor agitation * weight loss * guilt

Answer 27

DM specifiers Melancholia

Question 28

Bereavement vs. Depression

Answer 28

Now classified as Major depression if meet timeline DO NOT need extreme severity or suicide. Seen as trigger to episode ADD meds work

Question 29

Catecholamine hypothesis

Answer 29

NE lack is cause of Depression