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Human Behavior
Depression
15
Medical
Graduate
10/07/2009

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Cards

Term
Epidemiology
Definition
incidence = 400/100,000 annually; prevalence = 5000/100,000 (2x more women)
Term
Etiology
Definition
Genetics: 10% risk of 1st degree relative; assoc. with poverty and unemployment; no racial or ethnic variation
Term
What are the important stats about depression that I need to now?
Definition
men are more successful at suicide than woman are; after 55, men have more depression; 15% of elderly have depression if comorbid with physical illness
Term
Who has increased risk?
Definition
personal or family hx, multiple medical problems, unexplained physical complaints, chronic pain, overutilization of medical services
Term
What are the contributory factors?
Definition
older age, debilitating illness (HIV, MS, cancer), meds, stress (divorce or marital adversity), social isolation, poverty, unemployment
Term
What are the co-morbidities?
Definition
drug and alcohol use, other psychiatric diagnoses (PDs, schizophrenia)
Term
What does the acronym SIGECAPS mean?
Definition
Sleep disorder, interest deficit (anhedonia), guilt, energy deficit, concentration deficit, appetite disorder, psychomotor retardation or agitation, suicidality
Term
What do I have to identify before I diagnose Major Depressive Episode (MDE)?
Definition
For the same 2 week (or more) period at least 5 depressive symptoms are present, one of which is either depressed mood or loss of interest or pleasure
Term
What should I know about suicide?
Definition
8th most common cause of death among adults, 2nd among 15-24, 1% of pop. commits suicide, rates for men peak at 75 and for women 40-50s, less common among married, 10-15% hospitalized for depression
Term
Major Depressive Disorder (MDD)
Definition
• For the same 2 week (or more) period at
least 5 depressive symptoms are present,
one of which is either:
• Deressed mood or
• Anhedonia
• Along with any 3 or 4 (nearly daily):
• Significant weight loss without dieting (e.g.5%)
• Insomnia or hypersomnia
• Psychomotor agitation or retardation
• Feelings of worthlessness or guilt
• Decreased concentration
• Recurrent thoughts of death or suicide
Term
In addition to SIGECAPS, what else should I know about MDD?
Definition
it is not part of a mixed episode, symptoms cause significant impairment, symptoms are not due to substance use, symptoms are not associated with bereavement
Term
What does the DSM say about dysthymic disorder?
Definition
• Depressed mood most days for 2 yrs (1 for
children and adolescents, may be irritable
rather than depressed)
• Two or more:
• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration
• Feelings of hopelessness
• No two month period within the two (or
one) years without these symptoms
• No MDD
Term
What is the difference between a major depressive episode and MDD?
Definition
• Same as MDD except for the time
period. Symptoms must be present
for a two week period
Recurrent
• 2 month symptom free period
between MD Episodes
Term
So I treat it by doing the following:
Definition
talking, couseling, meds (SSRIs)
Term
Anything to know about meds?
Definition
r/o bipolar first, start low and go slow, meds take a while to work
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