This is a specific subset of Depressive disorders
Diagnosis of MDD
Symptoms: A. must have at least 1 of the following:
- depressive mood
- anhedonia Including the previous section there needs to be 5 overall.
- feelings of worthlessness or guilt
- suicidal ideation, plan or attempt
- fatigue or loss of energy
- sleep changes
- weight or appetite changes
- lack of cognitive ability
- psychomotor retardation or agitation B. Must have clinically significant distress or impairment C. Not attributable to anything else D. Not better explained bt different forms of schizophrenia spectrum disorders E. Never been a manic/hypomanic episode (or would be bipolar depression)
You can alsp have extra modifiers eg with seasonal pattern or with peripartum onset
Prognosis of MDD
Each time an episode presents the chance of a recurring episode heightens and the length of episodes increases.
Meihana factors of depression
physical health chronic conditions poor nutrition insufficent sleep environment life stressors trauma poverty disconnection from rootr spiritual health disconnection from spiritual idenitit lack of spiritual support unresulces spiritual distress mental and emotional health guilt hopelessness negative self talk rumination
4 winds colonisation marginalisation migration racism
Further assessment quesitons present symptoms frequency intensity duration impact of symptoms suicidal ideation onset background medical history substance use cultural history family history previous interventions
Epidemiology:
Prevalence: 5.7% but can be underreported Age of onset peaks to 19.5 yrs
Impact
2x likely to suffer from 1+ chronic disease 3x as likely to suffer from a pain related disorder 7x as likely to suffer from alcohol ro substance use Negatively effects family physical work and financial
Treatment/management
medication pros lower cost convenience speed cons side effects addication symptom relief isnt adequate
talk therapy pros medication long term chanfe meneage other areas of life limited side effects cons cost time dependant on patient morivations