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what is major depressive disorder MDD?
severe emotional disorder, presents with Hx of 1 or more major depressive episodes and No hx of manic/hypomanic episodes
what are the subtypes of MDD?
- post partum onset
- seasonal affective disorder SAD
what is present in a catatonic feature?
extreme psychomotor retardation almost paralyzed, withdrawn, negativity, no speech
what is present in melancholic feature?
severe endogenous depression not related to environmental stress, more associated with time of the day: worse early in the morning and tend to have suicidal ideation
what is present in post partum onset ?
4wks after childbirth, mom have eexcessive rumination and delusional thoughts about baby indicating increased risk of harm
what is present in season affective disorder SAD?
severe depressive episodes during fall/winter, ease up during spring/summer months
overeat, crave for carbs, no energy, reduced cerebral metabolic activity
what is present in atypical feature?
- overeat or oversleep (vegetative signs), high level of anxiety
- occur in younger individual often misdiagnosed
what is present in psychotic features?
presence of disorganized thoughts, delusions, hallucinations
what is dysthymic disorder DD?
- mild to moderate signs of depression, present most of the day, more days than not, for at least 2 yrs
- diagnosed early childhood, early adulthood
- at risk for developing MDD
what are statements given by pt and family related to DD?
- "Ive always been this way"
- "Theyve always been that way"
differentiate MMD and DD
presenting signs are almost same, difference is duration and severity of symptoms
what is one major health problem of elderly, at many times go untreated and increase their risk for suicide?
depression - not normal part of aging
what are the causes of depressive disorder?
diathesis stress model
what neurotransmitters are involved in the depression mood of individuals?
what is the function of serotonin?what is the effect of its deficiency?
regulate sleep, appetite, sex drives
sleep deprivation, decreased appetite/sex drive, poor impulse, irritability
what is the function of norepinephrine?what are the effects of its deficiency?
apathy, decreased responsiveness, slowed psychomotor activity
what are the other neurotransmitter believed to be involved in depressive moods?
acetylcholine, GABA, dopamine
in relation to hormonal regulation, what abnormality is present?
hyperactivity of limbic-hypothalamic-pituitary adrenal cortical axis
high levels of urine cortisol
what is diathesis stress model?
- take into account interplay of biology and environment
- people who are more at risk of developing MDD will not have full blown disease process unless an environment tirgger is present