Term
| What typical outcomes is Major Depressive disorder associated with? |
|
Definition
| significant morbidity, mortality, and physical disability |
|
|
Term
| What mood disorder causes more physical disability and social impairment that most other chronic dz's? |
|
Definition
| Major Depressive Disorder |
|
|
Term
| What is the 4th leading cause of worldwide disability? |
|
Definition
| Major Depressive Disorder |
|
|
Term
| By WHO estimates, in 2020 MDD will become what? |
|
Definition
| The 2nd leading cause of disability worldwide |
|
|
Term
| What is the lifetime prevalence of MD? |
|
Definition
7-12% of men
20-25% of women |
|
|
Term
| What is the point prevalence of MDD? |
|
Definition
|
|
Term
| What is the suspected cause for the gender gap in MDD? |
|
Definition
| biologic and sociocultural factors |
|
|
Term
| How often is MDD comorbid with other medical conditions? |
|
Definition
|
|
Term
| What is MDD often comorbid with? |
|
Definition
Parkinsons
pancreatic cancer
TBI
DM
CAD
arthritis
pulmonary
other terminal dz |
|
|
Term
| When does the first episode of MDD usually occur? |
|
Definition
|
|
Term
| What is MDD often confused with in elderly pts? |
|
Definition
|
|
Term
| What is the pathophysiology for MDD? |
|
Definition
|
|
Term
| If you have a parent with MDD, what is your risk for MDD? |
|
Definition
|
|
Term
| Is MDD in response to major life stressors? |
|
Definition
|
|
Term
| What are the suspected pathophysiologies of MDD? |
|
Definition
CNS synaptic dysfunction
CNS neurotransmitter concentrations |
|
|
Term
| What neurotransmitters are suspected in MDD causation? |
|
Definition
| norepinephrine and serotonin |
|
|
Term
| What is usually present when MDD first occurs? |
|
Definition
|
|
Term
| As MDD recurs, what happens to the 'stress' triggering effect? |
|
Definition
| it becomes less correlated; i.e. the MDD episodes can happen without any stress related trigger more often |
|
|
Term
| What is hypercortisolemia? |
|
Definition
| CNS dysfunction seen chronic MDD |
|
|
Term
| What happens to slow-wave and REM sleep in MDD? |
|
Definition
| slow-wave (restful sleep) goes down while REM (arousing) sleep increases |
|
|
Term
| What is the DSM-IV criteria for MDD? |
|
Definition
| 5 of 9 sx present for a 2 week period |
|
|
Term
| What two sx MUST be present for an MDD dx? |
|
Definition
persistent depressed mood
pervasive anhedonia (loss of interest of living) |
|
|
Term
| Is a depressed mood the same as depression? |
|
Definition
|
|
Term
| What are the DSM-IV sx for MDD? |
|
Definition
depressed mood
anhedonia
sleep disorder
change in appetite/weight
fatigue
psychomotor retardation or agitation
trouble concentrating/making decisions
low self-esteem or guilt
recurrent thoughts of death or suicidal ideation |
|
|
Term
|
Definition
| a nine item questionnaire used for MDD dx |
|
|
Term
|
Definition
| a two question tool used for screening for MDD |
|
|
Term
| What dz's is MDD a predictor for? |
|
Definition
DM
osteoporosis
CAD
Cerebrovascular dz |
|
|
Term
| If a pt already has CAD or HF, what does MDD increase the risk for? |
|
Definition
|
|
Term
| If a DM pt has MDD, what is seen more often? |
|
Definition
poor glycemic control
greater macrovascular complications
greater mortality |
|
|
Term
| What behaviors is MDD associated with? |
|
Definition
adverse health habits
smoking
poor diet
overeating
sedentary lifestyle
substance abuse |
|
|
Term
| In general, what is often seen in MDD pt's who are managing other medical conditions? |
|
Definition
| poor pt compliance/control of the condition |
|
|
Term
|
Definition
SSRI
SNRI
TCA
MAOI
St John's Wort |
|
|
Term
| What is dysthymic disorder? |
|
Definition
| a less severe form of MDD that is actually more chronic than MDD |
|
|
Term
| How is dysthymic disorder dx'd? |
|
Definition
| if pt has a depressed mood and at least two other sx's of depression for more than half of the days during the previous 2 years |
|
|
Term
| What sx's are associated with dysthymic disorder? |
|
Definition
mild depression
fatigue
anhedonia
low self-esteem/feel discouraged |
|
|
Term
| What are tx's for dysthymic disorder? |
|
Definition
|
|
Term
| What is the epidemiology for Bipolar? |
|
Definition
lifetime 3-6.5%
strong genetic link |
|
|
Term
| What are the three subclasses of Bipolor disorder? |
|
Definition
BP I
BPII
cyclothymic disorder |
|
|
Term
|
Definition
|
|
Term
|
Definition
| requires at least one episode of mania that lasts one week or longer |
|
|
Term
| What is the criteria for mania? |
|
Definition
hyperactivity
euphoria
insomnia
rapid speech
grandiosity or paranoia
racing thoughts
hypersexuality/reckless behavior |
|
|
Term
|
Definition
MDD with one episode of hypomania
Manic episodes are more controlled, less severe than BP I |
|
|
Term
| What are tx's for bipolar disorders? |
|
Definition
mood stabilizer
anti-psychotics
anti-convulsants
anti-depressants |
|
|
Term
|
Definition
|
|
Term
| What is biological marker for melancholia? |
|
Definition
lack of response to Dexamethasone Stress Test
blunted TSH response to exogenous parenteral administration of TRH |
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