Moses- Depressive Disorders

Question 1

Leading cause of disability and premature death in people aged 18 to 44 years.

Answer 1

Major Depressive Disorder

Question 2

The prevalence of MDD is among patients with chronic medical illnesses.

Answer 2

30-50%

Question 3

Up to of adults will have an episode of depression in their lifetime.

Answer 3

one-quarter

Question 4

What are some factors that are related to depression?

Answer 4

• Gender
• Age
• Marital Status
• Mental Health Diagnosis
• Biological Factors
• Genetic Factors
• Psychosocial Factors

Question 5

More severe major depressive illness occurs with those that begin with depression earlier/later in their lifetime?

Answer 5

earlier

Question 6

What age group is at greatest risk for depression?

Answer 6

elderly

Question 7

What are 5 high risk populations for depression?

Answer 7

• Postpartum Women
• Personal/Family History of MDD
• Advanced Age
• Neurologic Disorders
• Comorbid Systemic Physical Illness

Question 8

What are the 6 main depressive orders in the DSM?

Answer 8

Question 9

What is the timeline criteria for persistent depressive disorder (dysthrhymia)?

Answer 9

longevity of 2+ years

Question 10

Which depressive disorder is characterized by an irritated and angry mood?

Answer 10

Disruptive Mood Dysregulation Disorder

Question 11

What is the time criteria for PMDD?

Answer 11

symptoms 1 week before and after starting period. 2 weeks on and 2 weeks off

Question 12

How many symptoms must be present, what is the timeline criteria, and what needs to be noted about baseline functioning for a diagnosis of MDD?

Answer 12

5+ criteria met

same 2 week period

change (decrease) in baseline functioning- KEY piece

Question 13

Review the criteria for MDD

Answer 13

Question 14

What is the acronym that lists the clinical features of MDD?

Answer 14

SIGECAPS

Question 15

Screening tools are used to help with and

Answer 15

diagnosis and treatment

Question 16

What is the most common screening tool for depression?

Answer 16

PHQ-9

Question 17

What is the screening tool most commonly used for Post Partum depression?

Answer 17

Edinborough Depression Scale

Question 18

List the scores for the following screening tool criteria to be met?

• Mild Depression: Score
• Moderate Depression: Score
• Moderately Severe Depression: Score
• Severe Depression: Score
• Greater than or equal to considered a positive screen.

Answer 18

• Mild Depression: Score 5-9
• Moderate Depression: Score 10-14
• Moderately Severe Depression: Score 15-19
• Severe Depression: Score 20-27
• Greater than or equal to 10 considered a positive screen.

Question 19

There is/is not a huge overlap with major depression and medical illness?

Answer 19

is

Examples: endocrine/thyroid issues, cancer, sleep apnea, nutritional deficiencies

Question 20

What are the 2 major classes of drugs most commonly used to treat MDD?

Answer 20

SSRIs

SSNRIs

Question 21

Why is fluoxetine most commonly used if there is a risk for non-compliance?

Answer 21

longest half-life

Question 22

What are some reasons to use and not use Mirtazipine?

And what populations does this medicine work well and not well

Answer 22

helps with sleeping and eating (great for elderly and weight gain)

not good for young adult females

Question 23

Which antidepressant works well as an adjunct for the tx of resistant depression and as a tx for kids with ADD?

Answer 23

bupropion

Question 24

What are some common side effects of antidepressants?

Answer 24

sexual dysfunction/ decreased libido, weight gain, sedation

Question 25

What is the method of discontinuing use of antidepressants?

Answer 25

titrate down, do not stop cold turkey

Question 26

Describe the treatment goal of MDD?

Answer 26

remisson of symptoms, titrate to the max dose possible that keeps symptoms under control

Question 27

How long does it usually take to see benefit of antidepressant, and to see real changes?

Answer 27

up to 4 weeks for benefit up to 3-6 mnths for real changes

Question 28

What is the timeline criteria for maintenance of medications?

Answer 28

stay on board for 4, 9, even 12 mnths after the remission of symptoms (because of risk of relapse w/in first 6 mnths)

Question 29

What are 2 non pharmacological first line treatments that can be used for mild depression?

Answer 29

* Interpersonal Psychotherapy * Cognitive Behavioral Therapy

Question 30

Which non pharmacological tx are mainly used for tx resistant depression?

Answer 30

* Transcranial Magnetic Stimulation (TMS) * Electroconvulsive Therapy (ECT)