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Depressive Episode


Presentation

  • Mixed episodes tend to be severe when they occur; psychotic symptoms such as hallucinations and delusions, and suicidal thinking are frequently present.[mentalhelp.net]
  • Also present is some combination of altered appetite, weight, or sleep patterns, psychomotor agitation or retardation, difficulty thinking or concentrating, lack of energy and fatigue, feelings of worthlessness, self-reproach, or inappropriate guilt,[medical-dictionary.thefreedictionary.com]
  • […] and then adults, symptom presentation becomes more consistent with the DSM-5 criteria ( Table 1 ).[ncbi.nlm.nih.gov]
  • (In children and adolescents, this may present as an irritable or cranky, rather than sad, mood.)[psychcentral.com]
  • Self-reported measures of diminished concentration and attention are frequently observed in individuals presenting with MDE as part of MDD.[frontiersin.org]
Fatigue
  • Also present is some combination of altered appetite, weight, or sleep patterns, psychomotor agitation or retardation, difficulty thinking or concentrating, lack of energy and fatigue, feelings of worthlessness, self-reproach, or inappropriate guilt,[medical-dictionary.thefreedictionary.com]
  • Constant complaints of fatigue and low energy Thoughts of the affected person's worthlessness, guilt or shame plague him or her Concentration becomes more difficult to achieve than before Thoughts of the desirability of death and suicide People experiencing[mentalhelp.net]
  • […] including constant restlessness, pacing, or picking at one’s cloths (called psychomtotor agitation by professionals); or the opposite, a slowing of one’s movements, talking very quietly with slowed speech (called psychomotor retardation by professionals) Fatigue[psychcentral.com]
Feeling of Worthlessness
  • Also present is some combination of altered appetite, weight, or sleep patterns, psychomotor agitation or retardation, difficulty thinking or concentrating, lack of energy and fatigue, feelings of worthlessness, self-reproach, or inappropriate guilt,[medical-dictionary.thefreedictionary.com]
  • The low mood tone, inability to accomplish tasks, and general shut-down of the brain's ability to think clearly and rationally can lead to exaggerated feelings of worthlessness, misery and despair.[mentalhelp.net]
  • […] of worthlessness or excessive or inappropriate guilt nearly every day (e.g., ruminating over minor past failings) Diminished ability to think or concentrate, or indecisiveness, nearly every day (e.g., appears easily distracted, complains of memory difficulties[psychcentral.com]
Distractibility
  • […] also bipolar disorders and mood disorders. manic episode a period of predominantly elevated, expansive, or irritable mood accompanied by some of the following symptoms: inflated self-esteem, decreased need for sleep, talkativeness, flight of ideas, distractibility[medical-dictionary.thefreedictionary.com]
  • ., appears easily distracted, complains of memory difficulties) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideas without a specific plan, or a suicide attempt or a specific plan for committing suicide A depressed mood caused[psychcentral.com]
Flight of Ideas
  • See also bipolar disorders and mood disorders. manic episode a period of predominantly elevated, expansive, or irritable mood accompanied by some of the following symptoms: inflated self-esteem, decreased need for sleep, talkativeness, flight of ideas[medical-dictionary.thefreedictionary.com]
Indecisiveness
  • ., ruminating over minor past failings) Diminished ability to think or concentrate, or indecisiveness, nearly every day (e.g., appears easily distracted, complains of memory difficulties) Recurrent thoughts of death (not just fear of dying), recurrent[psychcentral.com]
Psychomotor Retardation
  • In other words, it’s not normal for the symptoms of bereavement to induce significant functional impairment, morbid preoccupation with worthlessness, suicidal thoughts, psychotic symptoms, or psychomotor retardation (a slowing of a person’s physical movements[psychcentral.com]
Hyperactivity
  • […] disorders and mood disorders. manic episode a period of predominantly elevated, expansive, or irritable mood accompanied by some of the following symptoms: inflated self-esteem, decreased need for sleep, talkativeness, flight of ideas, distractibility, hyperactivity[medical-dictionary.thefreedictionary.com]
  • Compared with adults, children and adolescents are at increased risk of behavioral activation/disinhibition (restlessness, jitteriness, hyperactivity), hypomania or mania, decreased height and weight, and new-onset suicidal thoughts or behaviors. 2, 32[ncbi.nlm.nih.gov]
  • Additive Neurocognitive Deficits in Adults with attention-deficit/hyperactivity disorder and depressive symptoms. Arch Clin Neuropsychol. (2011) 26:385–95. doi: 10.1093/arclin/acr033 PubMed Abstract CrossRef Full Text Google Scholar 26.[frontiersin.org]
Sexual Dysfunction
  • dysfunction, which may be important to consider for older adolescents ( Table 3 ). 32 TABLE 3: General treatment guidelines 15,19,34 Stages of Treatment Severity of Depression Treatment Recommendations 1 Mild to moderate Cognitive behavioral therapy[ncbi.nlm.nih.gov]

Treatment

  • Symptom severity predicts the initial mode of treatment ranging from psychotherapy to medications to combination treatment.[ncbi.nlm.nih.gov]
  • ., impulsivity) with ketamine treatment ( 82 ). However, the use of ketamine warrants further investigation for its application in the treatment of cognitive symptoms in patients with MDD.[frontiersin.org]
  • Full Title: A RANDOMIZED, 6-WEEK, DOUBLE-BLIND, PLACEBO-CONTROLLED, FLEXIBLE-DOSE, PARALLEL-GROUP STUDY OF LURASIDONE ADJUNCTIVE TO LITHIUM OR DIVALPROEX FOR THE TREATMENT OF BIPOLAR I DEPRESSION IN SUBJECTS ...[clinicaltrialsregister.eu]
  • Issued by: Guidance Issuing Office Center for Drug Evaluation and Research The purpose of this guidance is to assist sponsors in the clinical development of drugs for the monotherapeutic, combination, and adjunctive treatment of major depressive disorder[fda.gov]
  • Major Depressive Disorder and Bipolar Disorder: Differentiating Features and Contemporary Treatment Approaches. In Understanding depression. New York: Springer.[psychcentral.com]

Prognosis

  • Thus, when they do occur together, the depressive symptoms and functional impairment tend to be more severe and the prognosis is worse compared with bereavement that is not accompanied by major depressive disorder.[psychcentral.com]
  • Comorbidity of migraine and depression: Investigating potential etiology and prognosis. Neurology 60, 1308 – 1312 ( 2003 ). 21. Hyde, C.L. et al.[biorxiv.org]

Etiology

  • Comorbidity of migraine and depression: Investigating potential etiology and prognosis. Neurology 60, 1308 – 1312 ( 2003 ). 21. Hyde, C.L. et al.[biorxiv.org]

Epidemiology

  • Epidemiology and heritability of major depressive disorder, stratified by age of onset, sex, and illness course in generation scotland: scottish family health study (GS:SFHS ). PLoS ONE 10, e0142197 ( 2015 ). 41. 42.[biorxiv.org]
  • Epidemiological research suggests that depression constitutes the leading cause of disability worldwide ( 1 ).[frontiersin.org]
Sex distribution
Age distribution

Pathophysiology

  • Several regions of the brain, including the hippocampus, are negatively implicated in the pathophysiology MDD.[frontiersin.org]
  • The relationship of depression and diabetes: Pathophysiological and treatment implications. Psychoneuroendocrinology 36, 1276 – 1286 ( 2011 ). 36. Das, S. et al. Next-generation genotype imputation service and methods.[biorxiv.org]

Prevention

  • Full Title: A RANDOMIZED, DOUBLE-BLIND, PLACEBOCONTROLLED, FLEXIBLE-DOSE, PARALLEL-GROUP STUDY OF LURASIDONE ADJUNCTIVE TO LITHIUM OR DIVALPROEX FOR THE PREVENTION OF RECURRENCE IN SUBJECTS WITH BIPOLAR I DISO...[clinicaltrialsregister.eu]
  • […] educational, occupational, and social functioning. 2 Up to one third of adolescents who present to their primary care physician may present with an emotional disturbance, and 14% may screen positive for depression. 8 The Centers for Disease Control and Prevention[ncbi.nlm.nih.gov]
  • Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. The Lancet Neurology 13, 788 – 794 ( 2014 ). 28. Smith, D.J. et al.[biorxiv.org]
  • Targeted treatment of cognitive impairments in MDD may capitalize on modifiable determinants, focusing on prevention and pre-emption.[frontiersin.org]

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