HBM 08a: MDD

Question 1

Diagnosing MDD: At least (X) of (Y) listed symptoms of major depressive episode must be present for how long?

Answer 1

X = 5
Y = 9

For at least 2-week period

Question 2

Which symptom(s) must be present for MDD diagnosis.

Answer 2

Either:
1. Subjective/objective report of depressed mood
Or
2. Marked decline in interest/pleasure in most activities

Question 3

Typical depression results in weight (loss/gain) by (X)% over what period of time?

Answer 3

Loss;
X = 5
In a month

Question 4

Typical depression symptom is (over/under)-sleeping.

Answer 4

Under-sleeping (insomnia); in atypical depression, patient over sleeps

Question 5

Psychomotor (agitation/retardation) is symptom of depression.

Answer 5

Could be either

Question 6

T/F: concentration and memory problems could be symptom of depression.

Answer 6

True

Question 7

Aside from showing symptoms, what are the 3 other criteria for diagnosing MDD?

Answer 7

1. Distress or impairment in social/occupational fxn
2. Not caused by substance/med condition
3. No history of manic/psychotic episode

Question 8

T/F: depressed patients typically feel more depressed in evening.

Answer 8

False - in morning

Question 9

SWAG mnemonic, to identify (X).

Answer 9

X = depression

Suicidality
Weight loss
Anhedonia (loss of pleasure in activities)
Guilt

Question 10

What’s masked depression?

Answer 10

Depression presenting as physical symptom (ex: headache with unidentifiable cause)

Question 11

Biological factors of depression.

Answer 11

1. Heredity
2. Altered NT activity
3. Abnormal hypothalamic-pituitary axis

Question 12

Which genders/age groups have highest risk for MDD?

Answer 12

1. Females

2. Young people (unless elderly are chronically ill/widowed)

Question 13

Lost some Pharmacologic agents used to treat MDD.

Answer 13

1. Heterocyclic antidepressants
2. SSRIs
3. Monoamine oxidase inhibitors

Question 14

Most commonly used and effective treatment for MDD.

Answer 14

Pharmacologic agents

paired with psych treatment, like cognitive therapy

Question 15

List some prescription drugs that can cause depressive symptoms.

Answer 15

1. Anti hypertensives
2. Antineoplastic agents
3. Steroids

Question 16

T/F: steroids can cause elevated mood symptoms.

Answer 16

True - as well as depressive symptoms in some cases

Question 17

Stimulants, such as (X), are drugs likely to (depress/elevate) mood.

Answer 17

X = cocaine and amphetamines

Elevate (manic symptoms)

Question 18

T/F: withdrawal from stimulants causes manic episodes.

Answer 18

False - causes depression of mood

Question 19

Withdrawal of opioids commonly results in:

Answer 19

Depression of mood

Question 20

Withdrawal of sedatives commonly results in:

Answer 20

Depression of mood

Question 21

Diagnosis of bereavement is given for (X) period of time.

Answer 21

X = 2 months

Question 22

Why would (poor/wealthy) bipolar patients be more misdiagnosed as (X)?

Answer 22

Poor;
X = schizophrenic

Delay in seeking/access to treatment; become ill enough to show psychotic symptoms (like delusions)

Question 23

Average onset age of MDD.

Answer 23

40

Question 24

There’s greater risk of death from (X) in MDD.

Answer 24

X = all causes

Question 25

Prevalence of depression is (decreasing/constant/increasing) in US.

Answer 25

Increasing

Question 26

(X)% of people with MDD eventually commit suicide.

Answer 26

X = 15

Question 27

Mood disorders account for (X)% of suicides.

Answer 27

X = 50-70

Question 28

Suicide is more common in (young/elderly) and in (men/women).

Answer 28

Elderly; men

Question 29

If patient mentions suicide, you should:

Answer 29

Follow up with open-ended question to get more info

Question 30

T/F: euthanasia is illegal in all states.

Answer 30

False - legal in Oregon, Washington, Montana

Question 31

Potentially as many as (X)% of depressed patients are unaware/deny symptoms.

Answer 31

X = 50 | Masked depression

Question 32

In cancer patients, what's the best indicator of depression?

Answer 32

Concentration and excessive guilt (many other symptoms overlap with cancer)

Question 33

Which depression meds should be avoided in cardiac patients? Why?

Answer 33

Tricyclics; have more anticholinergic side effect; tachycardia/conduction disturbances

Question 34

(X) is one of only (Y) number of medications found useful in decreasing suicide rate/impulsivity.

Answer 34

``` X = lithium Y = two ```

Question 35

Cycle of despair includes:

Answer 35

Substance abuse to depression to violence and back to substance abuse