Lecture 7 (Theme 5) Flashcards
(18 cards)
What makes depression pervasive (doordringend)?
- Because it has always existed in human society.
How was depression/acedia looked at in the Middle Ages And what about melancholia?
- it was seen as a sin?
- Melancholia has been known since antiquity and was caused by black bile in your body.
What is the definition of depression (3)?
- Depression is a continuum where only the worst states are diagnosable
- A depressed mood most of the day, nearly every day. In combination in Anhedonia (no interest in pleasure/activities)
- Also includes things like weight loss/gain, sleep problems, agitation, worthlessness, loss of focus.
When is diagnosis of depression MDD given (3)?
- At least two core symptoms, like depressed mood (most of the day, all of the day) and Anhedonia.
- At least 4+ other symptoms (like sleep problems, agitation, fatigue)
- There must also be significant suffering/impairment in social/professional functioning.
What are three symptom groups of depression? Name examples.
- Cognitive Symptoms, like poor focus, hopelessness and suicidal thoughts.
- Neurovegitative symptoms, like sleep, appetite and psychomotor problems)
- Emotional symptoms, like sadness, depressed mood and loos of interest.
What are 6 mood disorders?
- Major Depressive Disorder (2+ weeks , 5+ symptoms)
- Persistent Depressive disorder, Dysthymia (2+ Years, 2-4 symptoms)
- Minor depression (older DSM) 2+ weeks, 2-4 symptoms
- Bipolar Disorder (Depressive episodes in addition to Manic episodes)
- Cyclothymic disorder
- disruptive mood dysregulation disorder
What are 7 specifiers for MDD (1 distress, 4 features, 1 onset, 1 pattern)
- WIth anxious distress
- With psychotic, melancholic, catatonic, atypical features
- With peripartum onset (within 4 weeks after childbirth, or before)
- With Seasonal Pattern
What is Differential Diagnosis in Depression? What are 4differentiating questions?
- Ruling out if symptoms are caused by another disorder
- Is it Unipolar (MDD) or Bipolar?
- Psychotic depression (psychotic features) or Schizophrenia? You look at the type/content of hallucination/delusion
- Depression or Substance Abuse?
- Depression or grief? you draw the line where something is (prolonged grief disorder) grief and when it becomes MDD.
What is suicidality, and how does it connect to depression?
- Suicidality is separate from depression, but often co-occurs with depression
- It is possible to be suicidal without depressive disorder.
What is the prevalence (year + lifetime) of Depression? what age is most hit and what income)
- The prevalence is 4.5-5 percent in a given year.
- The lifetime prevalence is 10%
- Middle age adults at the age of 15-65 are most hit.
- Lower middle income countries are mos hit. (high income countries the least)
What is the epidemiology of depressive episodes: how long do they last, what percent is chronic, what are recurrence rates and what predicts a higher recurrence rate? How about the interaction of environmental causes of depression and the amount of episodes?
- It lasts 6 months on average
- 12-34 percent have chronic depression that does not really stop
- 27-45 percent has a recurrence of another depressive episode
- This risk of recurrence increases with every additional depressive episode.
- As the amount of depressive episodes increase, it is harder to pin-point an environmental aspect that caused it.
What are depression comorbid disorder, gender differences (prevalence) and help seeking percentages?
- Comorbidity is: anxiety, substance use and personality disorder
- Females have 2 times more prevalence
- In high-income countries, 7-28% of people with depression seek help.
What is the prevalence depression in different groups of youths? What is the median onset age?
- toddlers have the lowest prevalence, then comes primary school age and adolescence and in young adults, it is the highest.
- The median onset is the age of 26 ( a bit earlier in lower income countries
What is genetic heritability of depression? what are 6 other risk factors
- 30-40 percent heritability, without one specific gene being identified.
- Other risk factors include: prenatal factors, substance abuse, obesity, childhood trauma and cognitive style and environmental stressors.
What is the Biopsychosocialmodel for disorders?
- Combines biological, social and psychological risk factors that together explain why someone develops a specific disorder.
- It is a complete model, but it is hard to use for predictions.
What is the Cognitive Model of Depression?
- It combines automatic Thoughts, Behaviors and Feelings.
- They influence each other, like your thoughts influencing how you behave and this impacts how you feel.
What are lower severity, middle severity and high severity treatment options for depression(5)?
- First watchful waiting, where you keep in contact, but no therapy yet
- Then bibliotherapy where the patient reads literature that can help them
- Psychotherapy is the first real step of therapy
- If this alone doesn’t work, you add antidepressants
- If all else fails, there is Electroconvulsive Therapy (seizures inducing). and Transcranial Stimulation.
What is known about the effectiveness of 3 psychological treatment options for depression? how can effectiveness be increased? how does it compare to pharmacotherapy?
- CBT, IPT (interpersonal therapy) and Psychodynamic therapy are effective
- They seem to be equally effective, but CBT has been studies the most.
- By combining Psychotherapy and Pharmacotherapy, it becomes more effective.
- Psychotherapy could be more effective on the long term compared to pharmacological therapy.
