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Depression Shreya 170

Depression is the most common psychiatric disorder, affecting women more than men, with a mean onset age of around 40 years. It is characterized by a range of symptoms including depressive mood, cognitive distortions, psychomotor changes, and physical symptoms, and is linked to biological, genetic, and psychological factors. The risk of suicide is heightened in individuals with marked hopelessness, particularly among older males and those who have communicated suicidal intent.

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9 views17 pages

Depression Shreya 170

Depression is the most common psychiatric disorder, affecting women more than men, with a mean onset age of around 40 years. It is characterized by a range of symptoms including depressive mood, cognitive distortions, psychomotor changes, and physical symptoms, and is linked to biological, genetic, and psychological factors. The risk of suicide is heightened in individuals with marked hopelessness, particularly among older males and those who have communicated suicidal intent.

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nyxkann
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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DEPRESSION

DEPRESSION

ROLL NOS;39,40,41,42
PRESENTED BY
SHREYA P
Roll no 170
Commonest psychiatric disorder.

Women > Men by two times ( Middle aged


females)

Mean age of onset is around 40 years

Major cause of disability and suicide.

If comorbid with a medical condition,


depression magnifies disability, diminishes
adherence to medical treatment and rehabilitation,
and may even shorten life expectancy
AETIOLOGY
A. Biological factors:

 Neurotransmitters disturbances: Decreased


levels of serotonin and norepinephrine

 Hormonal disturbances: Elevated HPA activity


(hypothalamic-pituitary-adrenal axis
activity) ,hypothyroidism .

 Neuroanatomical considerations: Decreased


activity in dorsolateral prefrontal cortex and
increased activity in amygdala
 B. Genetic factors:

• Linkage to locus for cAMP response element


binding protein (CREB 1) on chromosome 2.

• Serotonin transporter gene has also shown


linkage.
 C. Psychological theories:

COGNITIVE THEORY :
Cognitive triad of depression includes:

1. Negative view of self (ideas of worthlessness)

2. Negative views about environment – A tendency


to experience world as hostile

3. Negative view about future (ideas of


hopelessness).
FEATURES
1. Depressive mood
2. Depressive ideation/Cognition
3. Psychomotor activity
4. Physical symptoms
5. Biological functions
6. Psychotic activity
7. Suicide
8. Absence of underlying organic causes
DEPRESSIVE MOOD
 Sadness of mood
 Loss of interest in all activities(pervasive
sadness)
 Present all day (persistent sadness)
 Often not responsive to environment stimuli.
 Results in social withdrawal, decreased
function in interpersonal and occupational
areas.
 Decreased involvement in previously
pleasurable activities.(Anhedonia)
DEPRESSIVE IDEATION /COGNITION

 Sadness with pessimism.

 Results in
 Hopelessness
 Helplessness
 Worthlessness
 Other features; difficulty in thinking,
concentration, poor memory , lack of energy
etc.
PSYCHOMOTOR ACTIVITIES
YOUNGER PATIENTS OLDER PATIENTS
(<40 YRS)

• Slowed thinking & activities • Agitation ,


• Decreased energy • Anxiety restlessness
• Monotonous voice. • Feeling of uneasy
Severe form = Depressive stupor.
PHYSICAL SYMPTOMS
 Multiple physical symptoms
 Hypochondriacal features
 Reduced energy
 Easy fatigability
BIOLOGICAL FUNCTIONS
 Insomnia / increased sleep

 Loss of appetite and weight

 Loss of sexual drive


PSYCHOTIC FEATURES
 Delusions

 Hallucination

 Inappropriate behaviour

 Mood congruent features related to depressive


mood include delusions of poverty, stupor,
delusion of guilt.
SUICIDE
Increased risk of suicide in following;

a. Presence of marked hopelessness

b. Males; age>40; unmarried, divorced/widowed

c. Written/verbal communication of suicidal intent and/or


plan

d. Early stages of depression

e. Recovering from depression

f. Period of 3 months from recovery.


ABSENCE OF UNDERLYING ORGANIC CAUSE

 If secondary to organic causes, it should be


treated.

 Organic causes include:


• Genetic
• Neurological
• Hormonal
• Immunological

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