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What are the two major types of depression and what are the characteristics of each?
1. Major depressive disorder: 1 or more major depressive episodes that are at least 2 weeks long. This is a disorder of severity.
2. Dysthymic disorder: at least 2 years of depressed mood for more days than not. This is a disorder of chronicity
What is the DSM-IV-TR criteria for Major depressive disorder?
- Must have at least 5 of the criteria, one of which MUST be (1) or (2):
- 1. Depressed mood
- 2. Anhedonia (apathy)
- 3. Significant change in weight
- 4. Insomnia/hypersomnia
- 5. Increased/decreased psychomotor
- 6. fatigue/energy loss
- 7. feelings of worthlessness/guilt
- 8. diminished concentration/indecisiveness
- 9. recurrent death/suicidal thoughts
What are the specifiers of MDD according to the DSM-IV-TR?
Atypical, melancholic, catatonic, postpartum, psychotic, seasonal
What is atypical depression?
- - generally occurs in younger women
- - characterized by increased appetite/weight gain, hypersomnia (10+hrs/day), leaded paralysis, extreme sensitivity to interpersonal rejection, and mood reactivity in which the mood brightens considerably with positive events.
What is melancholic depression?
- - most often occurs in older adults
- - characterized by anhedonia/inability to be cheered up
- - following symptoms: depression worse in the am, early am awakening, psychomotor retardation/agitation, significant anorexia/weight loss, excessive and inappropriate guilt.
What are catatonic features of depression?
Significant psychomotor alterations (immobility, excessive motor activity, mutism, echolaila [repetition of words], inappropriate posturing)
What is psychotic depression?
- - When a person has hallucinations and delusions with the mood disturbance.
- - Tend to be mood-congruent
What is the DSM-IV-TR criteria for dysthymic disorder?
- A. Depressed mood for 2 years, with a depressed mood for most of the day, for more days than not
- B. 2 or more of the following:
- 1.poor appetite/overeating
- 2. insomnia/hypesomnia
- 3. low energy/fatigue
- 4. low self-esteem
- 5. poor concentration/difficulty making a decision
- 6. feelings of hopelessness
What are some of the causes of depression?
- Neurochemical: norepinephrine, serotonin, dopamine, dysregulation of GABA. The cells that the monoamines activate have lost the ability to respond
- Endocrine: Hypothalamic-pituitary-adrenal (HPA), which mediates the stress response, malfunctions and creates cortisol, thyroid, and hormonal abnormalities
- Circadian rhythm
- changes in brain anatomy: atrophy of white matter in frontal lobes, cerebellum, and basal ganglia
- psychological: Adverse early life experiences, intrapsychic conflicts, reactions to live events
What is included in a suicide risk assessment?
- 1. Plan: people with a plan are more serious about suicide and have a higher risk
- 2. Method: Lethality-some methods are more lethal than others (some methods give person more time to think it through)
- 3. Rescue: the person who will deceive possible rescuers as to where he/she is is higher risk
What is bipolar I disorder?
Characterized by a patient who swings between manic episodes and major depression
What is bipolar II disorder?
Person swings between a hypomanic episode and major depression
What is cyclothymic disorder?
Swing between hypomanic episode and dysthymia
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