Monthly Topic
One in 6 people aged 65 and over suffer from this illness and is associated with other co-morbid conditions such as stroke, cardiovascular disease, cancer, and rheumatoid arthritis.
What is Major Depression?
No evidence of prior episode.
What is single episode?
•Occurs while on treatment
•Pharmacologic or non-pharmacologic
What is remission status?
50-75% of older adults committing suicide did this in the month prior and 39% in the week prior.
What is "saw their doctor"?
At least two episodes that lasted minimum of 2 weeks separated by several months without significant mood disturbance
What is recurrent episode?
•Diminished symptoms such as does not meet DSM-V criteria
OR
•Complete resolution of symptoms < 2months
What is Partial Remission?
Per __{what authority}__________, dictates that ALL the following Criteria must apply for MDD:
•Symptoms cause clinically significant distress or impairment.
•Symptoms are not due to direct physiological effects a substance, or a general medical condition (e.g., hypothyroidism).
•Symptoms are present for two week period.
What is the DSM V Criteria?
•Usually 2 of (1) Depressed mood, (2) Loss of interest/enjoyment, (3) increased fatigability + 2 other symptoms
•Usually distressed by symptoms and has some difficulty with function and social activities, but will probably not cease to function completely
What is mild depression (5-9)-severity?
•Complete resolution of symptoms for > 2 months
What is full remission status?
Depression is considered Major if the patient meets 5 or more of the DSM V Criteria. Symptoms must be present for the same 2 week period and last at least 2 months or cause marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. Item 1 or 2 must be included as one of the 5 or more diagnostic criteria.
What is:
1.Depressed mood, most of the day, nearly every day
2.Loss of interest or pleasure, most of the day, nearly every day
•Usually 2 of (1) Depressed mood, (2) Loss of interest/enjoyment, (3) increased fatigability + 3 other symptoms
•Usually has considerable difficulty with function and social activities
What is moderate depression (10-15)-severity?
64 year old female with PMH of depression (two prior episodes that lasted several weeks and were several years apart), DM Type II, HTN, and dyslipidemia. Current medications include: Lexapro 20mg, Lisinopril 10mg, ASA 81mg and Simvastatin 20mg, all once a day. ROS- denies depression and anxiety currently; denies little interest or pleasure in doing things as well as denies feeling down, depressed, or hopeless. The rest of the PHQ9 questions are negative as well. She also reports that she has been on Lexapro for about one year and her depression symptoms resolved within 3 months of being on the drug, this episode was related to the loss of her husband. She plans to take this medication the rest of her life. How would you classify her diagnosis?
What is Major depressive disorder, recurrent, in full remission?
Documentation tip includes current status, response to treatment, and plans for continued care.
What is Best Practice?
•Usually all of (1) Depressed mood, (2) Loss of interest/enjoyment, (3) increased fatigability + 4 other symptoms of severe intensity
•Often accompanied by psychomotor agitation or retardation and/or somatic syndrome
•High risk of suicide
•Usually unable to function or participate in social activities
What is severe (15-27) depression?
Major depression is a diagnosis ________ to resolve.
What is unlikely?