Major Depressive Disorder Flashcards

Flashcards on Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD)

A mood disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in most activities, significantly impairing social, occupational, and other important areas of functioning, with symptoms lasting at least two weeks.

Melancholia (Hippocrates)

Excess black bile causing sadness, fear, and despair, seen as a natural imbalance.

Emil Kraepelin

Differentiated manic-depressive illness from schizophrenia and recognized depression as a distinct clinical disorder.

Sigmund Freud (1917)

Linked depression to grief and loss.

Multifactorial Approach

Biological, genetic, psychosocial, and lifestyle factors.

Types of Depression

Major Depressive Disorder, Persistent Depressive Disorder, Seasonal Affective Disorder, Premenstrual Dysphoric Disorder, Bipolar Depression

Prevalence of MDD in U.S.

Approximately 16% of the population annually in the U.S.

Etiology of MDD

Complex interplay of biological, genetic, psychological, and environmental factors including genetic predisposition, neurotransmitter imbalances and chronic stress or trauma.

Pathophysiology of MDD

Changes in limbic system regions, neurotransmitter dysregulation, elevated cortisol levels, and neuroinflammation.

Signs and Symptoms of MDD

Persistent low mood or irritability, anhedonia, feelings of guilt or worthlessness, difficulty concentrating, changes in appetite or weight, sleep disturbances, fatigue, psychomotor agitation or retardation, thoughts of death or suicide.

Diagnosis of MDD

Clinical interview based on DSM-5 criteria, including at least one major depressive episode lasting ≥ 2 weeks, causing significant distress or impairment, and ruling out other medical, psychiatric, or substance-induced causes.

Medical Management of MDD

Antidepressants (SSRIs, SNRIs, TCAs, MAOIs), psychotherapy (CBT, IPT, psychodynamic therapy), ECT, TMS, VNS, and lifestyle modifications.

Prognosis of MDD

Variable; many improve with treatment, but relapse is common. Early intervention and comprehensive treatment improve outcomes. Risk of suicide is significant if untreated.

Precautions for MDD treatment

Monitor for suicidal ideation, be aware of potential side effects of antidepressants, watch for changes in mood or energy.

Contraindications for MDD treatment

Avoid overstimulation, be cautious with interventions requiring high energy, monitor for interactions between physical health conditions and psychiatric medications.

ADLs

Activities necessary for basic self-care and functional living (e.g., mobility, feeding, toileting).

IADLs

Complex tasks that improve one's quality of life and ability to live independently (e.g., managing finances, meal preparation, using transportation).