Depression
A common language so clinicians, patients, families and services mean the same thing by "schizophrenia" or "depression".
Treatment at a glance
- SSRI (fluoxetine or sertraline) with psychotherapy
What our notes say
- A common language so clinicians, patients, families and services mean the same thing by "schizophrenia" or "depression". (Classification of Mental Disorders)
- To guide treatment: the diagnosis points to evidence-based options (for example lithium for bipolar disorder, SSRIs plus CBT for depression). (Classification of Mental Disorders)
- Pressured speech (mania); poverty of speech and mutism (depression, schizophrenia); slow, monotonous (depression); dysarthria or slurring (neurological, intoxication). (Introduction to Psychopathology)
- | Seen in | Schizophrenia, mania, psychotic depression, delirium | Schizophrenia, delirium, substance use, epilepsy | Delirium, anxiety, fatigue; can be normal | (Introduction to Psychopathology)
- | Anhedonia | Loss of interest or pleasure in previously enjoyable activities; a core feature of major depression and negative symptoms. | (Dictionary of Psychopathology)
- | Anergia | Lack of energy or physical drive; commonly seen in depression and negative symptom clusters. | (Dictionary of Psychopathology)
Study material on Depression
- Bipolar and Related Disorders
- Psychiatry Year 6 CAT: June 2023, psychopathology, psychosis, mood and child psychiatry, 30 MCQs
- Psychiatry Year 6 CAT: October 2023, violence, defence mechanisms, hallucinations and sleep, 20 MCQs
- Psychological Therapies and Non-Pharmacological Interventions
- Psychiatry Year 4 CAT: June 2023, schizophrenia, dementia, eating disorders and psychopharmacology, 29 of 30 MCQs
- CNS History Taking & Neurological Exam Guide | Clinical Skills
- Dictionary of Psychopathology
- Introduction to Psychopharmacology
- Biopsychosocial Formulation
- Psychiatry, Sociology, Anthropology and Psychology
Practice questions on Depression
A 65-year-old woman complains of extreme dry mouth, difficulty swallowing, and recurrent dental caries. She is on multiple medications for hypertension and depression. What is the most common cause of her xerostomia?
- Bilateral parotid gland obstruction by sialolithiasis
- Sjögren syndrome with anti-Ro and anti-La antibodies
- Radiation therapy damage to parotid glands
- Medications — anticholinergic and antidepressant agents
Answer: D. Medications are the most frequent cause of xerostomia, including anticholinergic, antidepressant, antihypertensive, and diuretic agents. Sjögren syndrome is the second most important cause. ---
Which condition causes respiratory acidosis due to respiratory depression?
- Anxiety disorder
- High altitude
- Opioid overdose
- Aspirin toxicity
Answer: C. ** Opioid overdose causes respiratory depression, leading to inadequate ventilation, CO2 retention, and respiratory acidosis due to decreased elimination of carbon dioxide. ---
Serotonin-specific reuptake inhibitors (SSRIs) are widely prescribed to treat clinical depression. Which of the following procedures do you think would most likely worsen symptoms in untreated depressed patients?
- Increase the concentration of serotonin in the brain
- Decrease the concentration of serotonin in the brain
- Give a serotonin autoreceptor antagonist (inhibits or reduce autoreceptor function)
- Give a drug that increases the vesicular release (in the synaps
- of serotonin
Answer: B. Since depression is associated with low serotonin levels and SSRIs work by increasing serotonin availability, decreasing serotonin concentration would worsen depressive symptoms. SSRIs prevent serotonin reuptake, keeping more serotonin available in synapses.
Which neurotransmitter is most commonly associated with the regulation of mood, and its dysregulation is implicated in mood disorders like depression?
- Dopamine
- Acetylcholine
- Serotonin
- GABA
Answer: C. Serotonin is a monoamine neurotransmitter widely known for its role in mood regulation, and its dysregulation is a key component of the monoamine hypothesis of depression.
Which neurotransmitter is most commonly associated with the regulation of mood, and its dysregulation is implicated in mood disorders like depression?
- GABA
- Norepinephrine
- Serotonin
- Dopamine
Answer: C. Serotonin plays a significant role in regulating mood, appetite, and sleep. Dysregulation of serotonin levels and signaling is strongly implicated in the pathophysiology of mood disorders like depression and anxiety.
Which neurotransmitter is most commonly associated with the regulation of mood, and its dysregulation is implicated in mood disorders like depression?
- GABA
- Norepinephrine
- Serotonin
- Dopamine
Answer: C. Serotonin is a key neurotransmitter involved in mood regulation. Dysregulation of serotonin pathways is a major factor in the development of mood disorders like depression and anxiety.