Flashcards in Exam 2 Mood Disorders: Depression Deck (16):
Major Depressive Disorder DSM criteria? (3)
A. Sxs ≥ 2wks including either depressed mood or anhedonia and 5+ sxs
B. Not attributed to drug, GMC, bereavement, other psych disorder
C. No hx of manic/hypomanic/mixed episodes
CHRONIC = > 2 yrs continuously
Major Depressive Disorder DSM criteria SYMPTOMS include? (9)
1) Depressed most of day, nearly every day (NED), kids irritable
2) Anhedonia in most everything NED
3) Significant weight/appetite ∆
4) Insomnia or hypersomnia NED
5) Fatigue/↓ energy NED
6) ↓ ability to concentration/think/decide
7) Feel worthiness, excess.inappropriate guilt
8) Psychomotor agitation/retardation
9) Thoughts of death w/ or w/o plan or attempt
Major Depressive Disorder (MDD) specifiers: Severity?
Mild, Moderate, Severe w/ or w/o psychotic features
Major Depressive Disorder specifiers: Catatonic?
w/ immobility, echolalia, echopraxia
Major Depressive Disorder specifiers: Melancholic?
Anhedonia worse in a.m.
w/ psychmotor ∆s,
C in elderly
Major Depressive Disorder specifiers: Atypical?
Rejection sensitivity (C in kids)
Major Depressive Disorder specifiers: Postpartum?
Onset w/i 4 wks
Major Depressive Disorder specifiers: Part/Full Remission?
Part = no longer meets criteria or no sxs < 2mo
Full = no sxs 2+ mo
Major Depressive Disorder specifiers: Seasonal?
Obviously comes and goes w/ season
MDD screening: Pt Health Questionnaire 9?
+ for MDD if answered NED to mood/anhedonia
5 other sxs as "more than half" or higher
MDD screening: Pt Health Questionnaire 9 Scores
0-4 = ?
5-9 = ?
10-14 = ?
15-19 = ?
20-27 = ?
0-4 = Not/minimal depressed, no tx
5-9 = Mild, watch and reeval at F/U
10-14 = Moderate, refer for therapy and meds
15-19 = Mod Severe, start meds and refer for therapy
20-27 = Severe, start meds and expedite referral
Dysthymia DSM Criteria? (7)
A. Depressed most of day, more days than not for 2+ yrs
B. 2+ sxs while depressed:
1) ↑↓ Appetite
2) ↑↓ Sleep
3) Fatigue/↓ Energy
4) ↓ Concentration/Decisions
5) ↓ Self-esteem
C. No major depressive episode during 1st 2 yrs
D. No hx of manic/mixed episode
E. Not w/ psych disorder
F. Not from drugs or GMC
H. Significant distress/impairment
MDD tx: Mild/Moderate?
CBT (Cognitive-Behavioral Therapy) or
IPT (Interpersonal Therapy)
MDD tx: Severe?
SUMMARY: MDD/Dysthmia have in common? (6)
1) Depressed mood
6) NO mania/hypo/mixed