MDD

Question 1

1 in how many people will experience some form of depression or anxiety in their lifetime.

Answer 1

5

Question 2

2015/16 statistics show that psychological distress including anxiety and depression is significantly higher among Maori by what %

Answer 2

10.5%

Question 3

2015/16 statistics show that psychological distress including anxiety and depression is significantly higher among Pacific by what %

Answer 3

11.3%

Question 4

2015/16 statistics show that psychological distress including anxiety and depression is 6.4% in what ethnicity

Answer 4

New Zealand European

Question 5

2015/16 statistics show that psychological distress including anxiety and depression is 6.1% for what ethnicity

Answer 5

Asian

Question 6

Psychological distress was highest among those of what age?

Answer 6

15-24 years (8.8%)

Question 7

2nd highest age group of Psychological distress?

Answer 7

25-34 years (8.4%)

Question 8

psychological distress was higher among which gender
across all age groups

Answer 8

Female

Question 9

Causes of MDD SFhPCtMSi

Answer 9

Stressful events (i.e. breakup of a relationship or financial trouble)

A family history of depression (genetics)

Physical illness

Stressful or traumatic events in childhood can lead to depression in later life

Particular medications can cause depression
in some people

Social isolation i.e. lack of support from friends and family

Question 10

DIAGNOSTIC CRITERIA Intro

Answer 10

Five (or more) of the following symptoms have been present during the same 2 week period and represent a change from previous functioning;
at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure

Question 11

DIAGNOSTIC CRITERIA

Depressed mood

Answer 11

Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (
Note: In children and adolescents, can be irritable mood.)

Question 12

DIAGNOSTIC CRITERIA

Markedly diminished interest

Answer 12

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every
day (as indicated by either subjective account or observation.)

Question 13

DIAGNOSTIC CRITERIA

Significant

Answer 13

Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of bodyweight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

Question 14

DIAGNOSTIC CRITERIA

Sleep behavior

Answer 14

Insomnia or hypersomnia nearly every day.

Question 15

DIAGNOSTIC CRITERIA

Psychomotor agitation

Answer 15

Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

Question 16

DIAGNOSTIC CRITERIA

How often does fatigue occur?

Answer 16

Fatigue or loss of energy nearly every day.

Question 17

DIAGNOSTIC CRITERIA

Feelings of worthlessness

Answer 17

Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly everyday (not merely self reproach or guilt about being sick).

Question 18

DIAGNOSTIC CRITERIA

What happens to concentration?

Answer 18

Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

Question 19

DIAGNOSTIC CRITERIA

Death

Answer 19

Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Question 20

Issues in diagnoses
What percentage of people who have depression also have anxiety disorder?

Answer 20

50%

Question 21

Issues in diagnoses
What percentage of people who have depression also have an SUD

Answer 21

20%

Question 22

Issues in diagnoses
Can Depression be a relapsing condition?

Answer 22

Yes

Question 23

Issues in diagnoses
What is common with Sub Threshold symptoms of Depression

Answer 23

It is common for people to experience sub-threshold symptoms between episodes i.e they do not meet all the criteria for the diagnosis yet remain disabled by the condition.

Question 24

Issues in diagnoses
What about culture can affect diagnoses?

Answer 24

Culture plays a part in how depression is expressed e.g. some people will report primarily bodily based symptoms rather than emotional or cognitive symptoms

Question 25

What is Grief?

Answer 25

GRIEF The grieving process is natural and unique to each individual and shares some of the same features of depression like intense sadness and withdrawal from customary activities.

Question 26

Expression of grief vs depression (mood)

Answer 26

grief: painful feelings come in waves, often intermixed with positive memories of the deceased. Depression: mood and thinking are almost constantly negative.

Question 27

Expression of grief vs depression (self esteem)

Answer 27

Grief: Self esteem is usually preserved Depression: corrosive feelings of worthlessness and self-loathing are common

Question 28

SCREENING Be alert to depression in people with a past history of depressive episodes and people with co-occuring long-term physical health conditions that impair daily living. ASK?

Answer 28

During the last month, have you often been bothered by feeling down, depressed or hopeless? During the last month, have you often been bothered by having little interest or pleasure in doing things?

Question 29

What is a useful screening tool for people who you suspect may be experiencing depression

Answer 29

PHQ9

Question 30

What is the treatment for a Mild–moderate depressive episode?

Answer 30

self-directed computerised CBT https://www.justathought.co.nz/depression structured group physical activity, behavioural activation (doing more of what bring joy, meaning and purpose or a sense of mastery) St John’s Wort, Omega 3 https://bluepages.anu.edu.au/index.php?id=lifestyle Rongoa Maori Brief counselling/talking therapy (focussed on resolving current issues) Antidepressant medication for people with a past history of depression being effectively treated this way or subthreshold symptoms persist despite trying other interventions

Question 31

How do you treat moderate-severe depression?

Answer 31

Antidepressant medication in combination with talking therapy (Interpersonal Therapy IPT, Cognitive Behavioural Therapy CBT, Acceptance and Commitment Therapy ACT) In addition; physical activity, Rongoa Maori, behavioural activation, Omega 3 ECT is sometimes used for treatment of severe depression. It is only considered when either a) nothing else has worked or b) it has been a successful treatment in the past. For many whaiora this remains a controversial treatment as a person may be under the Mental Health Act when it is administered and therefore experience it as being a treatment being given against their will.