MH: Chapter 14: Depressive Disorders (Part 1)
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Questions and Answers

What is Depression?

  • A rare genetic disorder
  • A condition caused by a lack of exercise
  • A physical illness due to a virus
  • A mental health disorder characterized by persistent sadness and loss of interest (correct)
  • Which of the following are symptoms of Depression? (Select all that apply)

  • Constant happiness
  • Sleeplessness or having too much energy
  • Low mood or sadness (correct)
  • Changes in appetite or weight (correct)
  • Difficulty concentrating or making decisions (correct)
  • According to Aaron Beck's Cognitive Theory of Depression, what significantly contributes to the onset and maintenance of depression?

  • Supportive relationships
  • Physical exercise
  • Positive thinking patterns
  • Cognitive distortions and negative thinking patterns (correct)
  • According to Beck's Cognitive Theory of Depression, which components make up the Negative Cognitive Triad?

    <p>Negative view of self, world, and future (B)</p> Signup and view all the answers

    Which of the following describes cognitive distortions in the Cognitive Theory of Depression? (Select all that apply)

    <p>All-or-Nothing Thinking (B), Overgeneralization (C)</p> Signup and view all the answers

    Which of the following statements about the attribution style in the Cognitive Theory of Depression is true?

    <p>Depressed individuals view their flaws as permanent and affecting all aspects of their lives. (A)</p> Signup and view all the answers

    Which of the following statements describes a key component of the Cognitive Theory of Depression regarding behavioral activation?

    <p>Withdraw and avoidance behaviors can exacerbate feelings of loneliness. (B)</p> Signup and view all the answers

    What is one of the main objectives of Cognitive Behavioral Therapy (CBT) as derived from the Cognitive Theory of Depression?

    <p>To help individuals identify and challenge negative thought patterns (B)</p> Signup and view all the answers

    Which of the following symptoms is NOT required to be present for a diagnosis of Major Depressive Disorder?

    <p>Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. (A)</p> Signup and view all the answers

    What is the minimum number of symptoms required to be present for a diagnosis of Major Depressive Disorder?

    <p>Five (C)</p> Signup and view all the answers

    Which of the following is NOT a symptom of Major Depressive Disorder, according to the DSM-5 criteria?

    <p>Increased self-esteem and confidence (D)</p> Signup and view all the answers

    Which of the following is a key difference in the presentation of Major Depressive Disorder in children and adolescents compared to adults?

    <p>Children and adolescents are more likely to experience irritability instead of depressed mood. (A)</p> Signup and view all the answers

    Which of the following is a key difference between a Major Depressive Episode and a Major Depressive Disorder?

    <p>A major depressive episode is a single, discrete period of depression, while a major depressive disorder involves recurrent episodes. (A)</p> Signup and view all the answers

    According to the DSM-5 criteria, which of the following is a factor that can be ruled out when diagnosing Major Depressive Disorder?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following is a possible cause for the symptoms of a depressive episode after a significant loss?

    <p>A normal and natural response to a loss (C)</p> Signup and view all the answers

    What is the key distinction between a Major Depressive Disorder and a depressive episode caused by a significant loss?

    <p>The duration of the symptoms. (C)</p> Signup and view all the answers

    When determining whether an individual is experiencing a major depressive episode in addition to the normal response to loss, what factor is explicitly NOT considered?

    <p>The individual's biological predisposition to depression (A)</p> Signup and view all the answers

    According to the content, which of these changes is a common presentation of major depressive episode in the context of loss?

    <p>Changes in eating habits (A)</p> Signup and view all the answers

    Which of the following is NOT a key factor, according to the text, for differentiating a major depressive episode from a normal response to loss?

    <p>The duration of the symptoms (A)</p> Signup and view all the answers

    What is the exclusion noted in the text regarding manic or hypomanic episodes specifically related to?

    <p>Excluding episodes that are caused by substance use or medical conditions (B)</p> Signup and view all the answers

    The content suggests that assessing a major depressive episode in response to loss requires:

    <p>Clinical judgment based on individual and cultural factors (D)</p> Signup and view all the answers

    Which of the following statements are true regarding Disruptive Mood Dysregulation Disorder (DMDD)? (Select all that apply)

    <p>Frequent temper outbursts are a symptom of DMDD. (C), DMDD is characterized by severe and persistent irritability. (A), DMDD generally affects children and adolescents. (D)</p> Signup and view all the answers

    What is a key feature of Disruptive Mood Dysregulation Disorder (DMDD) regarding the age of onset?

    <p>Symptoms must be present before the age of 10. (A)</p> Signup and view all the answers

    Which of the following are key features of Disruptive Mood Dysregulation Disorder (DMDD)? (Select all that apply)

    <p>Chronic irritability or anger nearly every day (C), Frequent temper outbursts occurring three or more times per week (A)</p> Signup and view all the answers

    What is a key feature of Disruptive Mood Dysregulation Disorder (DMDD) regarding symptom duration?

    <p>Symptoms must be present for at least 12 months and occur in more than one setting. (C)</p> Signup and view all the answers

    Which of the following statements are true regarding the key features and exclusions of Disruptive Mood Dysregulation Disorder (DMDD)? (Select all that apply)

    <p>DMDD must be differentiated from typical behavior issues in children. (C), DMDD can only be diagnosed in children who do not exhibit symptoms of other mood disorders. (D)</p> Signup and view all the answers

    What is the total score range for the PHQ-9 assessment?

    <p>0 to 27 (D)</p> Signup and view all the answers

    Which score range indicates moderately severe depression on the PHQ-9?

    <p>15-19 (C)</p> Signup and view all the answers

    How many questions does the PHQ-9 include to evaluate symptoms?

    <p>9 questions (A)</p> Signup and view all the answers

    What symptom is NOT explicitly evaluated in the PHQ-9?

    <p>Feeling anxious or nervous (D)</p> Signup and view all the answers

    Which of the following feelings is assessed by the PHQ-9?

    <p>Feeling down, depressed, or hopeless (A)</p> Signup and view all the answers

    Which score range indicates minimal or no depression on the PHQ-9?

    <p>0-4 (A)</p> Signup and view all the answers

    Which score range indicates mild depression on the PHQ-9?

    <p>5-9 (B)</p> Signup and view all the answers

    Which score range indicates moderate depression on the PHQ-9?

    <p>10-14 (C)</p> Signup and view all the answers

    Which score range indicates moderately severe depression on the PHQ-9?

    <p>15-19 (D)</p> Signup and view all the answers

    Flashcards

    Major Depressive Episode

    A period characterized by depressed mood, loss of interest, and other symptoms not better explained by other disorders.

    Cultural Norms of Distress

    Societal standards that influence how individuals express grief and emotional pain.

    Exclusion Criteria

    Conditions that must be ruled out to diagnose a major depressive episode, such as schizoaffective disorder or substance-induced episodes.

    Common Symptoms of Depression

    Signs indicating a major depressive episode, including changes in hygiene, sleep, and eating habits.

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    Clinical Judgment

    The exercise of professional discretion while evaluating a patient's symptoms and history in context.

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    Major Depressive Disorder (MDD) Criteria

    Five or more symptoms for two weeks, with depressed mood or loss of interest.

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    Depressed Mood

    Feeling sad, empty, or hopeless most of the day, nearly every day.

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    Loss of Interest

    Markedly diminished interest or pleasure in almost all activities nearly every day.

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    Weight Changes

    Significant weight loss or gain (5% in a month) or appetite changes.

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    Sleep Disturbances

    Insomnia or hypersomnia nearly every day.

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    Fatigue

    Feeling of fatigue or loss of energy nearly every day.

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    Feelings of Worthlessness

    Feeling excessive guilt or worthlessness nearly every day.

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    Suicidal Ideation

    Recurrent thoughts of death or suicide without a specific plan.

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    PHQ-9

    A screening tool with 9 questions to assess depression severity.

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    PHQ-9 Symptom Examples

    Questions assess interest, sleep, energy, appetite, self-worth, concentration, and suicidal thoughts.

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    PHQ-9 Scoring Range

    Scores range from 0 to 27, indicating severity of depression.

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    Interpretation of PHQ-9 Scores

    Interpret total scores: 0-4 (minimal), 5-9 (mild), 10-14 (moderate), 15-19 (moderately severe), 20-27 (severe).

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    Symptoms of Depression in PHQ-9

    Includes lack of interest, feeling down, sleep issues, energy loss, appetite changes, and suicidal thoughts.

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    Study Notes

    DSM-5 Criteria for Major Depressive Disorder

    • Criteria A: Five or more symptoms present for two weeks, representing a change from previous functioning. At least one symptom must be depressed mood or loss of interest.

    • Exclusions: Symptoms not due to another medical condition.

    • Symptom 1: Depressed Mood: Subjective feelings of sadness, emptiness, or hopelessness, or observed tearfulness (irritable mood in children/adolescents).

    • Symptom 2: Loss of Interest/Pleasure: Markedly diminished interest or pleasure in most activities.

    • Symptom 3: Weight Change: Significant weight loss/gain (more than 5% in a month) or noticeable changes in appetite. (Note: Children assessed for failure to gain expected amount).

    • Symptom 4: Sleep Disturbance: Insomnia or hypersomnia (excessive sleepiness) almost every day.

    • Symptom 5: Psychomotor Disturbance: Agitation or retardation (observable by others, not just subjective feelings).

    • Symptom 6: Fatigue/Loss of Energy: Persistent fatigue or loss of energy.

    • Symptom 7: Feelings of Worthlessness/Guilt: Feelings of worthlessness, excessive or inappropriate guilt (potentially delusional).

    • Symptom 8: Cognitive Difficulties: Impaired ability to think, concentrate, or make decisions.

    • Symptom 9: Suicidal Thoughts: Recurrent thoughts of death, suicidal ideation (without plan), suicide attempt, or planning a suicide.

    • Criteria C: Symptoms cause significant distress or impairment in daily functioning (social, occupational, other).

    • Criteria D: Symptoms not due to substance use or another medical condition.

    • Criteria E: Criteria A-C together form a major depressive episode.

    • Criteria F: Grief and loss: Responses to significant loss—e.g., bereavement—may resemble depression. Clinical judgment is needed to carefully consider if a major depressive episode exists in addition to or separate from a normal reaction to loss.

    • Criteria G: Major depressive episode is not better explained by other conditions like schizophrenia-spectrum disorders.

    • Criteria H: No prior manic or hypomanic episodes.

    • Criteria I: Exclusion does not apply to substance-induced or medically-caused manic/hypomanic episodes.

    Common Presentation of Depression

    • Behavioral Changes: Changes in demeanor.
    • Affect Changes: Flat, tearful, distant affect.
    • Hygiene Changes: Changes in hygiene habits.
    • Sleep/Eating Changes: Changes in sleep and eating patterns.

    Patient Health Questionnaire (PHQ)

    • Screening tool for assessing mental health, particularly depression and anxiety.

    • Consists of a series of questions that help healthcare providers evaluate the presence and severity of depressive symptoms, as well as other mental health conditions.

    • The PHQ-9 is the most common version used for screening and diagnosing depression.

    • PHQ-9 assesses symptoms over two weeks.

    • Questions cover:

      • Little interest or pleasure in doing things
      • Feeling down, depressed, or hopeless
      • Trouble falling asleep or staying asleep, or sleeping too much
      • Feeling tired or having little energy
      • Poor appetite or overeating
      • Feeling bad about yourself, or that you are a failure or have let yourself or your family down
      • Trouble concentrating on things
      • Moving or speaking so slowly, or being fidgety or restless
    • Thoughts of self-harm: Includes thoughts of being better off dead or hurting oneself.

    • Scoring: Each question rated 0-3, total score 0-27:

      • 0-4: Minimal or no depression
      • 5-9: Mild depression
      • 10-14: Moderate depression
      • 15-19: Moderately severe depression
      • 20-27: Severe depression

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    Description

    This quiz covers depression definition and symptoms, Aaron Becks Cognitive Theory of Depression, DSM-5 criteria for Major Depressive Disorder, Disruptive Mood Dysregulation, and the Patient Health Questionnaire (PHQ)

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