DSM says what?
What is the approximate prevalence of major depression in the general US population?
15% (6-8% of primary care patients)
This medication would be most appropriate for a patient who is depressed and would like to stop smoking.
What is bupropion
This is an absolute contraindication for ECT in a neurologically normal patient with psychotic depression.
What is no absolute contraindications to ECT
Someone experiencing social withdrawal, disorganized behavior, and auditory hallucinations for 5 months may be diagnosed with this.
What is schizophreniform disorder
This percentage of depression diagnoses are missed by PCP?
It has been estimated through several studies that the rate of missed diagnoses of depression approaches 50%
How do you differentiate grief from loss?
in grief the predominant affect is feelings of emptiness and loss, while in MDE it is persistent depressed mood and the inability to anticipate happiness or pleasure.
Fluvoxamine is approved for what condition, but not depression?
OCD
This risk factor increases your risk for MDD 3-fold.
A family history of depression is another risk factor, as first-degree relatives of individuals with MDD have a threefold increased risk of being affected by MDD themselves. 47 It is widely accepted that MDD is a heritable disorder, but the genes carrying susceptibility remain to be identified
This category of coping mechanisms is associated with development of depression.
Neuroticism is a robust predictor for the development of a psychiatric illness at some point during the life cycle, and it is often associated with low self-esteem, depression, and anxiety.
What treatment options are indicated for treatment resistant depression and psychotic depression?
Antidepressant with antipsychotic; ECT
Define persistent depressive disorder
depressed mood (although it can be irritable mood in children/adolescents for more than 1 year) is present for more days than not, for at least 2 years in addition to three or fewer of the following symptoms (insomnia or hypersomnia, reduced interest or pleasure, excessive guilt/feelings of worthlessness, reduced energy or fatigue, diminished ability to concentrate or make decisions, loss or increase of either appetite or weight, psychomotor agitation or retardation, thoughts of suicide or death/suicidal behavior)
What is an acceptable alternative medication to SSRIs for a patient who does not want to take traditional pharmaceuticals?
St John's wart - has MAO-I properties and is forst line if SSRIs are refused
Peripartum depression is diagnosed during what timeframe?
Any time during pregnancy until 4 weeks postpartum
Many patients with this disorder suffer from co-morbid dysthymia, major depression, and alcohol abuse. They may also become victims of physical and emotional abuse due to their lack of assertiveness. Because these patients are indecisive, require excessive reassurance, and need so much direction, their careers are unlikely to advance.
Dependent PD
Major depression may progress to persistent or recurrent episodes of detachment or estrangement from one's self and feel like an automaton or like he or she is living in a movie. This is better known as what?
Depersonalization
What is the prevalence of anxious subtype depression among depressed patients?
the prevalence of anxious depression was approximately 45%. 67 Patients with anxious depression tend to have a slower response to treatment and are less likely to respond to antidepressant treatment than are those without anxious depression. 8
Combining an SSRI with an MAO-i could result in what condition
The serotonin syndrome is characterized by alterations in cognition (e.g., disorientation and confusion), behavior (e.g., agitation and restlessness), autonomic nervous system function (e.g., fever, shivering, diaphoresis, and diarrhea), and neuromuscular activity (e.g., ataxia, hyperreflexia, and myoclonus).
This medication helps control gambling addiction and alcohol and opiate abuse.
Naltrexone - mesolimbic dopamine pathway (rewards) inhibition
These variations to the typical symptoms make the diagnosis of atypical depression.
Hypersomnia rather than insomnia
increased appetite and wt gain
leaden paralysis vs psychomotor disturbance
hypersensitivity to interpersonal rejection
The psychodynamic formulation conceptualizes a patient's condition by addressing what 3 factors?
Predisposing, Precipitating, Perpetuating (including untreated depression
What percentage of depressed patients attempt suicide?
about 21% of patients suffering from recurrent depressive disorders attempt suicide. It has been estimated that about two-thirds of completed suicides occur in depressed patients.
Serotonin, NE (largest), and DA are produced in these areas of the brain.
Raphe nucleus, locus coeruleus, substantia nigra and ventral tegmental area
How many people with PTSD also experience clinical depression?
Nearly 60% of men and 45% of women with PTSD report more than three co-morbid psychiatric conditions. Major depressive disorder (MDD) is among the most common of co-morbid conditions for both men and women, affecting nearly 50%
What are the criteria for recurrent brief depressive episode
MDD for 2-14 days monthly for 12 consecutive months and not associated with menstrual cycle
This diagnosis is seen in an elderly patient with multiple comorbidities, who is aware of their declining cognitive function, poor concentration, who answers "I don't know" to simple questions
Pseudodementia - often acute onset, vs dementia which is insidious and chronic