Term
| Major Depressive Disorder Criteria A |
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Definition
| 5 or more of the following present concurrently for at least 2 weeks and cause a change in functioning. One of them must be depressed mood or anhedonia. 1) depressed mood 2)anhedonia 3) significant weight loss or gain or change in appetite 4) insomnia or hypersomnia 5) psycomotor agitation or retardation 6) fatique 7) feelings of worthlessness or guilt 8) unable to concentrate or is indecisive 9) recurrent thoughts of death, suicidal ideation or attempt |
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Term
| Major depressive disorder criteria B, C, D, E |
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Definition
B) criteria not meet for mixed episode C) significant distress or impairment
D) not due to medical or substance
E) not due to bereavement |
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Term
| Major Depressive Disorder Criteria A, B, C, for single and recurrent episodes |
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Definition
| A) single - one MDE, recurrent - two or more MDE, B) not otherwise accounted for by schizoaffective or any psychotic disorder C) there has never been a manic, mixed, or hypomanic episode |
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Term
| Major Depressive Disorder Etiology |
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Definition
Family studies and twin studies but not to many adoption studies done,
1 parent with depression risk is 30-40%,
2 parents with depression risk is up to 70%,
Monozygotic twins 40-69%,
Dizygotic twins 15%, Biological abnormalities are not the cause,
No biological test for MDD it's a clinical diagnosis,
Biological data is inconsistent,
Decreased REM latencies (how long it takes from when you fall asleep to when you first start dreaming (on avg 45min – 1 hour)). • People who are depressed have:
o Shortened REM latency
o Initial REM is longer
o Less time in deep sleep
• Sleep cycle is the first thing to get altered when depressed people are taking medication, Younger the age when you have your first episode the higher the risk of relative |
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Term
| Major Depressive Disorder Treatment |
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Definition
• Fairly effective for most people
• Talk therapy
• Cognitive and interpersonal
• Medications (antidepressive)
• Meds in combination with psychotherapy
• ECT
• 60% has a good response to treatment
• 10-15% has a moderate response
• If psychotic features are present they should always be preferred for antipsychotic and antidepressive
• Must get history during diagnosis evaluation
• Ask about relatives
• If family members have a history of bipolar are at risk for being kicked into manic depressive episode |
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Term
| Major Depressive Disorder Epidemiology |
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Definition
• One of the more prevalent in population 12-15%
• Life time prevalence rates 8-15%
• Sex ration: male to female 1:2.5
• Age of onset: birth to death
• Mean age for depression tends to be in the mid twenties to mid thirties
• No race differences
• Single men more likely then married men
• Married women more likely then single women
• No racial or ethic differences |
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Term
| Major Depressive Disorder Course and Prognosis |
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Definition
• A third of people with this disorder only have one episodes
• Onset may be acute or indicious
• Average duration 6-8months, some have durations over 1 year (40%)
• A person must be symptom free for two months for us to consider that a new episode is starting
• After symptoms leave still stay on antidepressants 6 months after then gradually go off of them
• Treatment works well for depression but often people are untreated or never seek treatment
• There are plenty non medication treatment like cognitive therapy
• Prognosis is reasonably good, If psychotic symptoms are present the prognosis is not as good. |
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Term
| Major Depressive Disorder Associated Features |
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Definition
• Suicide rate is high almost 10-15%
• Significant anxiety (often have a cormorbid anxiety disorder)
• OCD is sometimes present, if they were OCD before the depression will probably make it worse
• Increased risk of alcohol abuse (especially in men)
• Increased use of other substances
• Try to self medicate
• Family disruptions
• Academic, social, employment problems
• Antidepressants lack street value and are not addictive |
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Term
| Major Depressive Episode Subtypes/Specifiers |
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Definition
1. Melancholic – 4 or more (sever anhedonia or lack of reactivity must be one)
• Sever anhedonia or lack of reactivity
• Early morning awakening
• Marked psychomotor disorder
• Sever loss of weight or appetite
• Excessive or inappropriate guilt
• Distinct quality of mood (is different from what they felt like when someone close to them died)
• Diurnal Variation – significantly worse in the morning; 2. Atypical
• Hypersomnia
• Mood reacitivty
• Significant weight gain
• Leaden paralysis (bodies feel heavy)
• Hypersensitivity to interpersonal rejection 3. Postpartum Onset - onset within 4 weeks postpartum 4. Catatonic - two or more of the following: • Motoric immobility
• Excessive motor activity
• Extreme negativism or mutism
• Echolalia or echopraxia
• Peculiarities of voluntary movements |
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