Summary
Depression Part 1 Complete Summary - 3.4 Affective Disorders 2024
- Course
- Institution
Complete and extensive summary for week 1 of the course 3.4 Affective Disorders, year 2023/2024. Grade received = 8.3!
[Show more]
Seller
Follow
lindej03
Content preview
3.4 Affective DisordersWeek 1
Depression Part 1
,What is Depression? → Overview
Herrman et al (2022)
Time for United Action on Depression: a Lancet-World Psychiatric
Association Commission
Executive summary
● Depression → leading cause of avoidable suffering
● Few communities & governments understand and acknowledge it as distinct from other
troubles
● This article aligns knowledge from many fields, synthesized evidence from many
contexts and generated actionable recommendations for many stakeholders
● Depression is common
○ Distinct from sadness, misery, despair
○ Profound suffering, impairs social functioning & economic productivity
○ Associated with premature mortality & physical illnesses
● Depression is heterogeneous
○ Experienced with various combinations of signs & symptoms, severity levels,
trajectories
○ The term in this case used broadly, does not relate to one diagnostic system or
category
● Core features have been described over thousands of years (universal)
○ Before the existence of classifications
○ It is not a modern condition or an invention of biomedicine or only experienced by
certain groups
● Each person experiences a unique combination of factors that lead to depression
○ Proximal adversities can trigger episode
○ Interact with genetic, environmental, social, developmental vulnerabilities &
resilience factors
○ Embrace the complexity of the disorder → go beyond brain-based or
social-environmental paradigm
● Individual level → detection and diagnosing of depression early is crucial to
recovery (staged approach)
○ Clinical formulation co-designed by the person with the experience, caregivers if
appropriate & clinicians is important to person-centered care
○ Accommodates heterogeneous presentation & unique personal stories, varies in
complexity & needs, resources
○ Adopting a staged approach to prevention and care is pragmatic for reaching
clinical decision about interventions that are evidence based
, ■ Low intensity early interventions aimed at interrupting and emerging
episode
■ Long-term multimodal care for people with recurrent/persistent depression
■ Range of intermediate interventions
○ Collaborative care models offer an evidence-based way for health systems to
implement staged approach to prevention & care (personalized at scale)
● Communities and professionals should support people with depression
○ Active role prevents stigma and helps meet needs of those unmet
○ Provides information about the condition & treatment possibilities
○ This will help those that experience people with recurrent depression and
advocate for greater resources
● Public health approach to depression is needed
○ Depression has social structural determinants and great severity, breadth and
durability and persistence for many people
○ Consequences include loss of lives and diminution of educational and work
opportunities and social connections, harm to future generations (impact of
parental depression
○ Preventative and health promoting actions at population & individual level is
crucial in lowering prevalence
○ Early detection and sustained care as needed
○ Collectively these interventions will promote overall health and achieve
sustainable development goals
● Healthcare practitioners should consider depression as a condition that affects
different people in different ways
○ Frequently accompanies other multifactorial illnesses & likely to complicate &
prolong the course of these conditions
○ Practitioners will be rewarded by efforts to integrate depression care in their
practice → better outcomes, priority to therapeutic alliance, addressing rights &
needs
● Public health & policy makers & researchers need to integrate depression
prevention into broader agendas
○ Mental health is central aspects of universal health coverage
○ New methods should be devised to optimize prevention, care, recovery
○ Approaches should be accessible in diverse resource contexts → profound
effects on those living in poverty & adversity
○ People with lived experiences of depression should be engaged in the design &
implementation of policies, services and research
Introduction
● Strides have been made in mental health awareness and prevention strategies
worldwide but still hampered by several issues (poor understanding, discrimination &
stigmatization)
● Depression is very heterogeneous & a global health crisis & found in all cultures
● It is not a biological disorder and simply a medical problem or social problem
, Section 1 → what is depression?
● Current diagnostic approaches
○ Conceptualized as a syndrome → associated
with stress & interference with personal functions
○ 5/10 symptoms have to be present for most of the
day, nearly every day for at least 2 weeks
○ Very similar ICD-11 & DSM-5 criteria
■ Hopelessness about the future is only
present in ICD
■ Diminished drive is a very predictive
symptom but in neither classification →
should be added in future
■ Other symptoms not in classification →
lack of mood reactivity, anger, irritability,
psychic anxiety, somatic components
● Continuous or categorical & question of severity
○ More controversial than the list of symptoms is
the amount of symptoms (at least 5)
■ Studies argued subthreshold depressions did not differ from diagnosable
depression in risk for future episodes, family history of mental illness,
comorbidities, functional impairment
■ Clinical utility of 5 symptom threshold has not been confirmed
○ Nuclear depressive syndrome → similar to melancholic depression
■ Most severe form
○ Depression is continuous rather than categorical
■ Threshold issue still not solved
■ Continuum of sadness to depression → reinforced medicalization of
sorrow
○ Subsyndromal depression should be its own syndrome (different from sadness)
○ Different levels of severity remain to be validly characterized → mild, moderate,
severe are rarely used in clinical practice
■ Usually scale of measurement instrument used → continuous
■ Symptoms may not have the same weight → bad way to measure
■ Complicated vs uncomplicated depression
● Psychopathological or oversimplification?
○ It is more than just severe sadness
○ Illness like symptoms, detachment from environment, feelings of inhibition
○ Somatic symptoms
● Higher order dimensions & specifiers
○ Often coexists with anxiety & bodily distress → could be different presentations of
the same underlying phenomenon (higher order category of disorder)
■ Subpopulations experience depression with different symptomatology
■ Different types of depression exist
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lindej03. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.77. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75632 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now