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Depressive Disorders Criteria and Treatment (Major Depressive Disorder (At…
Depressive Disorders Criteria and Treatment
Major Depressive Disorder
At least 5 symptoms including (1) depressed mood and/or (2) loss of pleasure. Symptoms present for at least 2 weeks and change functioning
Episodic disorder but can become chronic, average # of episodes is 4, major episodes tend to recur in 2/3 ppl
e.g. significant weight loss, sleeping too much/little, fatigue, psychomotor retardation (can't move)/agitation (restlessness), feelings of worthlessness difficulty concentrating, recurrent thought of death/suicide
Persistent Depressive Disorder (dysthymia)
Depressed mood for most of the day, for more days than not, for at least 2 years (1 year for children/adolescents)
At least 2 of the following during that time: poor appetite/overeating, sleeping too much/little, poor self esteem, trouble concentrating, feelings of hopelessness
Symptoms do not clear for more than 2 months at time, not less serious bc less symptoms --> it is chronic and impairs functioning, more risk of suicide
Premenstrual Dysphoric Disorder
In most menstrual cycles, 5+ symptoms present in final week before menses, improving within few days of menses onset
Including 1 or more: affective lability, irritability, depressed mood, anxiety
Including 1 or more: decreased interest in usual activities, difficulty concentrating, lack of energy, change in appetite, sleeping too much/little, subjective sense of being overwhelmed, physical symptoms
Disruptive Mood Dysregulation Disorder
Severe recurrent temper outbursts in response to common stressors, out of proportion in intensity or duration to the provocation
Unrelated to childhood/developmental disorders, occur 3 times a week, persistent negative mood in between outbursts on most days, negative mood observable by others
Depressive Disorders
MDD prevalence ~ 16%, dysthymia ~2.5%, twice as common in women, three times more common in low SES, symptoms vary across cultures (subjectivity, physical or psychological symptoms, etc),
General predictors? Distance from equator, fish consumption (known to reduce prevalence of depression), wealth disparity and family cohesion
Median age now ~17-23, symptoms change over life span (children = somatic symptoms, adults = distractibility), usually comorbid with other disorder (60% comorbid anxiety), other comorbidities - sexual dysfunction, personality disorders, substance-related
Psychological Treatment
Interpersonal therapy: focuses on depression caused by IP problems
Cognitive therapy: altering negative thought patterns, behavioural activation therapy, mindfulness-based CT
Biological Treatment
SSRIs - increases serotonin but side effects: physical agitation, sexual dysfunction, insomnia, etc
MAO inhibitors (MAO breaks down dopamine, serotonin): serious consequences if consuming tyramine (found in red wine, cheese, etc) and if mike with everyday medications, typically last line of treatment and works best with atypical features
Tricyclic antidepressants: side effects are blurred vision, dry mouth, drowsiness, weight gain