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Summary Textbook of psychiatry - H7.1 Depressieve stoornissen $4.27
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Summary Textbook of psychiatry - H7.1 Depressieve stoornissen

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Textbook of psychiatry
H7.1 Depressive disorders

A depressed mood is pathological if its intensity and duration are out of proportion to the
cause. It becomes a disorder if the depressed mood is combined with other symptoms,
constituting a depressive episode.

 Depressive disorders only comprise depressive episodes, unlike bipolar disorder

Classification of depressive disorders (DSM-5):
- Depressive disorder
- Persistent depressive disorder
- Premenstrual dysphoric disorder
- Substance/medication-induced depressive disorder
- Depressive disorder due to another medical condition


Syndromes:
Depressive disorder:
It is characterized by 1 or more depressive episodes.

Affective symptoms:
 Depressed mood
 Loss of interest or pleasure in day-to-day activities (anhedonia)

 at least one of these 2 symptoms must be present (key symptoms)
 mood symptoms can fluctuate in severity during the day
 typical: patients feel worst in the morning and gradually feel better

Physical symptoms:
 Fatigue
 Anergia (lack of physical energy)
 Sleep problems
 Anorexia (reduced appetite)
 Weight loss
 Constipation
 Loss of libido
 Amenorrhoea in women
 Various sleep symptoms
o Most typical: waking up early, several hours earlier than normal
o Difficulty falling asleep and waking up frequently during the night
o Sleeping for extremely long periods and waking up unrefreshed

Cognitive symptoms:
 Problems mainly in the areas of concentration, memory, judgement and the form
and content of thought
o Feeling worthless

, o Overvalued and/or misplaced guilt
o Indecisiveness
o Thoughts of despair
o Hopelessness
o Helplessness
o Preoccupation with death or suicide
o Loss of self-confidence
o Incapable of doing very much
o Expecting the worst from the future
o Suicidal thoughts
o Retarded speed of thought
 Slowed thoughts or even stopping
 Not thinking clearly
 Not being able to make decisions
 Thoughts going round in circles (inefficiency of thought)

Conative symptoms:
 Changed psychomotor function
o Retardation
o Agitation (restlessness, pacing up and down and hand wringing)
o Slowed motor function
o Reduced facial expression
o Lack of spontaneous movements
o Collapsed posture
o Downcast gaze
o Delayed, monosyllabic answers
 Changed motivation
 Changed behaviour

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