Depressive Disorders
Depressive disorders involve the presence of a sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.
Diagnostic Criteria (SIGECAPS)
To diagnose Major Depressive Disorder (MDD), a patient must have 5+ symptoms (including depressed mood or anhedonia) for at least 2 weeks:
- Sleep disturbances
- Interest loss (anhedonia)
- Guilt/feelings of worthlessness
- Energy loss/fatigue
- Concentration difficulties
- Appetite/weight changes
- Psychomotor agitation/retardation
- Suicidal ideation
Key Depressive Conditions
| Condition | Key Features |
|---|---|
| MDD | Full criteria met for 2+ weeks. |
| Persistent Depressive Disorder (Dysthymia) | Depressed mood for $\ge 2$ years; symptoms are less severe than MDD. |
| Premenstrual Dysphoric Disorder | Mood lability, irritability, and depressive symptoms in the week before menses. |
High-Yield Clinical Notes:
- Suicide Risk: Always assess for suicidal ideation, intent, and plan. Safety planning is paramount in acute management.
- Treatment Approach: A combination of pharmacotherapy (SSRIs, SNRIs, etc.) and psychotherapy (CBT, Interpersonal Therapy) is often more effective than either alone.
- Medical Mimics: Hypothyroidism, anemia, vitamin $B_{12}$ deficiency, and neurological disorders (e.g., Parkinson’s) must be ruled out during the evaluation.