Lectures 10 & 11-Depression Flashcards Preview

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Flashcards in Lectures 10 & 11-Depression Deck (23):
1

To dx major depressive disorder ____ (or more) of the following nine symptoms have been present during the same ___-week period and represent a change from previous functioning; at least one of the symptoms is either _____ mood or ____ of interest or pleasure.

1. depressed mood

2. loss of interest or pleasure

3. weight gain/ loss or decrease/ increase in apetite

4. Insomnia/ hypersomnia

5. Psychomotor agitation or retardation

6. Fatigue

7. Worthlessness or inappropriate guilt (delusional)

8. Diminished concentration & decision making

9. Recurrent thoughts of death, suicide+/- plan

five; 2; depressed; loss

2

Easy mnemonic to remember DSM depression criteria:

SIG-E-CAPS

S leep disturbance

I nterest/pleasure reduction

G uilt, feelings of worthlessness

E nergy loss, fatigue

C oncentration/attention impairment

A ppetite changes

P sychomotor symptoms

S uicidal ideation

3

Mnemonic _____ is used to differentiate between normal sadness and depression (have at least 1 of the following)

SWAG;

Suicidality – serious thoughts (ideation) or attempts at killing oneself

Weight Loss – >5% loss of body weight w/o medical cause

Anhedonia – loss of pleasure/interest in previously enjoyable activities

Guilt – feeling responsible for negative life events w/o reason

4

Other Characteristics of MDD: Atypical depression – more likely to have ____ gain and ___somnia

weight; hyper

5

Other Characteristics of MDD: Pseudodementia – cognitive symptoms in depressed _____ often misdiagnosed as “dementia” (short term memory loss)

elderly

6

Other Characteristics of MDD: Diurnal variation _____ depressed in AM, better in PM. Melancholic type depression (complete _____ with early morning wakening)

more; antodonia

7

Other Characteristics of MDD: Psychomotor symptoms– _____ complaints: body aches, headaches; Can be ______ or Retardation

physical; Agitation

8

What is seasonal affective disorder? Treatment?

Seasonal Affective Disorder (SAD)

MDD usually associated with shorter days in winter

Treat with full-spectrum bright light exposure therapy, psychotherapy, antidepressants

9

What is masked depression?

Depressed patients presenting with vague physical ailments but unaware/in denial of their depression

Seem stoic

Seek primary care for psychomotor or somatic symptoms instead

More typically seen in elderly patients, obsessive-compulsive/narcisstic personalities, eastern europeans

10

Biological causes of depression:

1. Monoamine ____ levels of Dopamine (DA), Serotonin (SR), Norepinephrine (NE)

2. Monoamine Receptor _____ Theory (receptor _____ due to low amount of monoamines)

3. ____ of neurotrophic factors and neurodegeneration?

4. ____ transporter gene

Deficiency; Excess; upregulation; Loss; Serotonin

11

Psychosocial causes of depression?

Ability to cope with life stressors – Resilience

Low self esteem, negative outlook

Personality traits

Addiction

Learned helplessness

Catastrophic loss

Anger turned inward? = I am mad at someone for sitting in my seat and I get mad at myself

Incapacity via
hibernating? = Incapacity via hibernating = quit med school to be engineer, parents were docs

Learned helplessness and automatic thoughts?

Social disconnect?

12

High # of receptors and/or low # of transmitter = ____

Depression

13

Are there both Genetic and Environmental Risk Factors in Depression?

yes

14

More depressions make you get into a state of depression (get stuck)—so intervene ____

Depression may be a neurodegenerative disease, as you get _____, you get more depressed

early; older

15

In neurodegenerative hypothesis of depression antidepressants that affect serotonin and/or norepinephrine activity may affect neuronal survival and growth by decreasing glucocorticoid levels and ____ BDNF levels.

increasing

16

Depression on imaging = _____ dorsolateral prefrontal cortex & _____ amygdala

hypoactive; hyperactive

Anything in psychiatry = cold in front, hot in the middle

17

Prevalence of depression is greater in _____, elderly who are ill or widowed, and there is co-morbitidy of _____ abuse and _____ anxiety.

women; substance; generalized

18

SSRI's, SNRI's, & NDRI's are the fron tline ______ with the least side effects

antidepressants

19

What is the most effective treatment for acute depression =

shock treatment (electroconvulsive therapy)

20

Other _____ Techniques include:

Vagus Nerve Stimulation (VNS)

Transcranial Magnetic Stimulation (TMS)

Deep Brain Stimulation (DBS)

Transcranial Direct Current Stimulation (TDCS)

Neurostimulation

21

Some evidence claims psychological treatment + medication is _____ effective than either treatment modality on its own; however, therapy alone is available.

more

22

A patient with autoimmune disease must take cortisol pills daily at high dose. Which of the following might explain why depression is more likely to occur in this patient?

1 Increasing cortisol increases serotonin

2 Increasing cortisol decreases norepinephrine receptors

3 Increasing cortisol decreases brain neurotrophic factors

3 Increasing cortisol decreases brain neurotrophic factors

23

A 48 year old woman is in the midst of her 4th depression. Which statement is the most accurate?

1 She will likely remit from this depression and have them less often given her age and gender

2 She will likely get depressed more quickly even when her stress levels are low from now on

3 She will likely be less depressed as she has learned how to cope with her depression over the years

2 She will likely get depressed more quickly even when her stress levels are low from now on