Management of Depressive Mood Disorders Flashcards
(49 cards)
What is the DSM diagnostic criteria for diagnosing Major Depression
Pt must have 5/9 of the symptoms for at least 2 weeks, and one of them MUST be either: depressed mood or loss of interest or pleasure in doing things (and 4 others)
What are the 9 symptoms included in the major depression criteria
- Depressed mood
- Loss of interest or pleasure
- Significant change in weight or appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Impaired concentration or ability to make decisions
- Thoughts of suicide or self harm
What patient population is most likely to experience symptoms of thoughts of suicide or self harm
Elderly are highest risk
What are the atypical symptoms of seasonal depression
A pt will experience increased appetite and increased sleep
What is the criteria for minor depression
Pt must have 2-4 of the 9 symptoms of major depression and it MUST include on of the following: depressed mood or loss of pleasure or interest
What does SIGECAPS stand for
Sleep disturbance Interest Guilt Energy change Concentration Appetite Psychomotor retardation or agitation Suicidal
What is considered a score of severe depression on the PHQ-9
Score > or = to 20
What is considered a score of moderate/severe depression with the PHQ-9
15-19
What is considered a score of moderate depression with the PHQ-9
10-14
What is considered a score of minor depression with the PHQ-9
5-9
What is considered a normal PHQ-9 score
0-4
What are vegetative symptoms of depression
Vegetative symptoms of depression are physiological or are related to body function such as sleep/appetite/energy/sexual interest
What are the emotional symptoms of depression
Crying spells
What are the cognitive symptoms of depression
poor concentration
low self esteem
What are the treatment-resistant/depressive sub-types
atypical depression double depression psychotic depression severe and melancholic depression co-morbidity- psychiatric or medical psychosocial stressors
How many patients with 1st depression have a 2nd depression
about half
How much does a second episode of depression increase the risk of getting a third
70-80%
How much does third depression increase the risk for a fourth
80-89%
What happens to depressive episodes with age
The get longer and more frequent
What is melancholic depression
Major depression with an emphasis on lack of pleasure or lack of reactivity to pleasure with three or more:
- depressed mood worst in the morning
- early morning awakening
- psychomotor agitation or retardation
- significant weight loss
- inappropriate guilt
What medications do melancholic depressive pts respond to best
TCA or Norepi reuptake inhibitors
What are the s/s associated with melancholic depression
Depressed mood worst in the morning Early morning awakening Psychomotor agitation or retardation Sig. WL Inappropriate guilt
What is required to have a dx of persistent depressive d/o
- Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation of others, for at least to years and the presence of two or more of the classic depression sxs
- During the 2 year period of the distrubance the person has never been without sx for more than 2 months at a time
- No Major Depressive Episode has been present during the first 2 years
What is the exception for dx persistent depressive disorder in pts that are <18 years old
The symptoms are only required to be persistent for 1 year, not two
