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Major Depressive Disorder

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Updated 2011-06-14 03:08

Summary

Major Depressive Disorder and other mood disorders.

Symptoms (Must have 1 of the 1/2 and 5 of the 5/9)

Question Answer
1/2Depressed mood
1/2Loss of Interest or Pleasure
5/9Depressed mood most of the day nearly every day
5/9Marked diminished interest or pleasure in almost all activities most of the day nearly every day
5/9Significant weight loss (or gain)
5/9Insomnia (or hypersomnia)
5/9Psychomotor disturbances (agitation or retardation)
5/9Fatigue
5/9Feelings of worthlessness or inappropriate guilt
5/9Diminished ability to think or concentrate, indecisiveness
5/9Recurrent thoughts of death or suicide ideations
Time>2wks, >2mnths if bereavement
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Subtypes

Question Answer
MelancholicSevere and responsive to biological treatment
Chronic>2 yrs
SeasonalIn winter and autum when days are shorter. Hypersomnia, Hyperphagia, Psychomotor slowing.
PostpartumOnset within 4 weeks of giving birth
AtypicalHysteric Dysphoria. Weight Gain, Hypersomnia.
CatatonicStuporous, blinted affect, extreme withdrawal, waxy flexibility. Responds to ECT.
PseudodementiaLike dementia with Hx of depressive disorder
Psychotic featuresHallucinations or delusions associated with depression
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Other Mood disorders

Question Answer
Major DepressiveUnipolar depression
Bipolar IManic episodes with or without depression
Bipolar IIDepressive episode with or without hypomanic episode
DysthymicLess server than Major Depression, > 2yrs
CyclothymicLess server than Major Depression, Recurrent mood swings, Less
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DDx

Question Answer
MedicalHypothyroidism, Mercury, HIV, Parkinsons, Substance abuse
SchizophreniaPronounced psychosis, Incongruent mood
Grief< 2mnths
Personality DisorderAxis II, can be simultaneously diagnosed
Somatiform DisorderPain, GI symptoms, Sexual symptoms, pseudo neurological symptoms
Eating DisorderBulimia, Anorexia nervosa
Anxiety DisorderPanic attack disorder, Generalized anxiety
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Tx

Question Answer
SSRISertreline, Citalopram, Fluoxetine,
PsychosocialCBT, family, group, interpersonal, Psuchoanalytical
SNRIVenlafaxine
TCAamitriptyline
MAOIPhenelzine, slegiline
ECTMostly for more severe eg Catatonic
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