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PAI > Week 8: Depression > Flashcards

Week 8: Depression Flashcards

1
Q

List the depressive disorders from the DSM

A
  • major depressive episode
  • persistent depressive disorder
  • disruptive mood regulation disorder
  • premenstrual dysphoric disorder
  • substance/medication induced depressive disorder
  • unspecified depressive disorder
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2
Q

List the difficulties with diagnosing depression

A
  • not straightforward
  • both under and over diagnosed
  • only half of depressed people recognised as such
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3
Q

Briefly describe a major depressive episode

A

Symptoms where there are marked stressors e.g. workplace bullying, job loss, breakups, bereavement

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4
Q

Briefly describe persistent depressive disorder

A

For a two year period, full intensity or low level

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5
Q

Briefly describe disruptive mood regulation disorder

A
  • For children under 18

- Diagnosis for children so we don’t have to give them anti depressants and mood stabilisers

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6
Q

What is the common theme of DSM-5 depressive disorders?

A

The presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that affect the individual’s capacity to function

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7
Q

Reactive depression is tied to

A

Life stressors; us ‘reacting’ to things happening to us

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8
Q

Recurrent depression is tied to

A

More biological depression, is more amenable to meds

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9
Q

List the ‘5 or more’ over a 2 week period for Major Depressive Disorder

A
  • depressed mood
  • diminished interest in pleasure/anhedonia
  • weight/appetite change
  • sleep problems
  • psychomotor agitation or retardation
  • fatigue
  • feelings of worthlessness or guilt
  • poor concentration/indecisiveness
  • suicidal ideation
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10
Q

Primary depression…

A

Causes a problem

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11
Q

Secondary depression…

A

The problem has lead to it

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12
Q

Describe the mixed features specifier

A

Allows for the presence of up to 3 manic symptoms, for those who do not meet manic episode criteria

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13
Q

Describe the anxious distress specifier

A

Presence of anxiety

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14
Q

Depression recovery rate with treatment?

A
  • 80% within two years of onset
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15
Q

List three types of assessment

A
  • clinical interviews
  • psychometric assessments
  • asking if they have felt depressed this week
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16
Q

List some areas you can ask about to get the history of the problem

A
  • onset
  • fluctuation
  • context
  • stressors
  • past episodes
  • psychiatric history
  • medical history
  • substance use history
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17
Q

What is the Black Dog model?

A

Some clients position on the highly biological end of the spectrum and respond well to medication, and others are on the reactive end of the spectrum and respond well to psychotherapy. There are also people in the middle.

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18
Q

List three self report and clinician rating scales

A
  • BDI and BDI-II
  • Center for epidemiological studies depression inventory
  • HAM-D
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19
Q

Describe clinical use of the beck depression inventory

A
  • 21 items, self report
  • scored by summing up ratings
  • not a diagnostic tool - screening tool
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20
Q

Minimal depression cut off (BDI)

A

0-13

21
Q

Limitations of the BDI-II

A
  • self report and self perception has the potential for catastrophizing
  • more than usual questions
  • too many words
22
Q

Describe the Hamilton depression rating scale

A
  • clinician rated
  • takes 20-30 mins
  • more focus on physical symptoms
  • 17 items (+4 not scored)
23
Q

What are the cut offs for the hamilton depression scale

A
  • 10-13 mild
  • 14-17 mild to moderate
  • > 17 moderate to severe
24
Q

Scarring model

A

Experiencing depression leads you to having more depressions

25
Q

Response rate to antidepressants

A

60%

26
Q

Response rate to CBT

A

60%

27
Q

Response rate to combination of CBT + antidepressants

A

85%

28
Q

Placebo response rate

A

42-47%

29
Q

Onset

A
  • how long have you been like this?
  • would your friends and family describe you this way?
  • how was premorbid functioning?
30
Q

Fluctuation

A

Are you like it all the time, or only certain situations?

31
Q

Context

A

What seems to have triggered it?

32
Q

Psychiatric history

A
  • have you seen a psychologist/therapist before?

- have you been depressed before?

33
Q

Depressive pseudodementia

A

Depression symptoms trigger/become similar to dementia

34
Q

Substance use history

A

Have you had depressants?

35
Q

Describe the CES-D

A
  • self report screening instrument
  • depressed affect, positive affect, somatic and retarded activity, and interpersonal
  • scores about 27 = severe depression
36
Q

Geriatric depression scale

A
  • screening tool for patients 60+
37
Q

Environmental factors associated with depression

A
  • family history
  • early childhood experience
  • stress
  • low levels of social support
  • generally undesirable events
38
Q

Neuroticism/anxiety and depression

A
  • predisposition to negative affect

- may be from innate genetic factors

39
Q

Pessimism

A

Negative cognitive triad: Viewing the world through a negative lens

40
Q

Rumination

A

Regurgitating bad thoughts and getting caught up on them

41
Q

Maladaptive beliefs and depression

A
  • all or nothing thinking
  • unhelpful beliefs about the world
  • fortune telling, catastrophizing
42
Q

Distraction

A

Designed to temporarily stop the flow of negative thoughts that contribute to depression

43
Q

Thought stopping

A

Used when the client is overwhelmed by ruminative thinking or intrusive imagery

44
Q

Visualisation

A

Being able to remove yourself from the depression by visualising a better circumstance

45
Q

Mild depression cut off (BDI)

A

14-19

46
Q

Moderate depression cut off (BDI)

A

20-28

47
Q

Severe depression cut off (BDI)

A

29-63

48
Q

What is the MDD diagnostic code based on?

A
  • single or recurrent episode?
  • mild, moderate or severe
  • presence of psychotic features
  • remission status

PAI (11 decks)

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