The Zed C. O. G

24/01/2025

👏

31/07/2023

psychiatric and mental health 3,2
Clinical_medicine

Major Depressive Disorder

🩺 definition
• history of one or more Major Depressive Episodes

🩺 epidemiology
• prevalence: male 2-4%, female 5-9% (M:F = 1:2)

• mean age of onset: ~ 30 years

🩺 etiology
• genetic
65-75% MZ twins
14-19% DZ twins

• neurotransmitter dysfunction at level of synapse (decreased activity of serotonin,
norepinephrine, dopamine)

• psychodynamic (e.g. low self-esteem)

• cognitive (e.g. negative thinking)

🩺 risk factors
• s*x: female

• age: onset in 25-50 age group

• family history: depression, alcohol abuse, sociopathy

• childhood experiences: loss of parent before 11 years old, negative home environment (abuse, neglect)

• personality: insecure, dependent, obsessional

• recent stressors (illness, financial, legal)

• postpartum

• lack of intimate, confiding relationships (social isolation)

🩺 diagnosis
• history of one or more MDE

• absence of a previous manic, hypomanic, or mixed episode

🩺 classification
• MDD, with psychotic features (with hallucinations or delusions; these may be mood congruent)

• MDD, chronic (lasting 2 years or more)

• MDD, with melancholic features (quality of mood is distinctly depressed, mood is worse in the
morning, early morning wakening, severe weight loss, excessive guilt, psychomotor retardation)

• MDD, with atypical features (increased sleep, weight gain, leaden paralysis, chronic
rejection sensitivity)

• MDD, with postpartum onset (see Postpartum Mood Disorders section)

• MDD, with seasonal pattern (pattern of onset at same time each year)

🩺 depression in the elderly
• accounts for about 50% of acute psychiatric admissions in the elderly

• affects about 15% of community residents > 65 years old

• high su***de risk due to increased lethality and decreased
communication of su***de attempt due to social isolation

• su***de peak: males aged 80-90; females aged 50-65

• often present with somatic complaints (e.g. changes in weight, sleep,
energy) or anxiety symptoms rather than classic depression

🩺 treatment
• biological: antidepressants, lithium, electroconvulsive therapy (ECT)

• psychological: psychodynamic, cognitive, behavioural, family, and group therapy

• social: vocational rehabilitation, social skills training

🩺 differential diagnosis for MDE
• adjustment disorder with depressed mood

• bereavement

• dementia

• mood disorder due to GMC

• substance induced mood disorder

• anxiety disorder

12/05/2023

20/04/2023

Fridays! Virtual Clinical Educational Grand Round is on with the Faculty of Nursing.
Topic: Antepartum Haemorrhage, 21st April, 2023, 12hrs Friday on Zoom.

Antepartum Haemorrhage (APH) is bleeding from the birth canal after the 24th week of pregnancy. It can occur at any time until the second stage of labour is complete; bleeding following the birth of the baby is postpartum haemorrhage.

The Q&A session is open for your participation. Grand rounds are a platform for you to learn and interact with your colleagues and professors.

Zoom link:
https://us06web.zoom.us/j/5061154711?pwd=dG9CcTRCRTkrOURTbGZib2YrSzZuQT09

Meeting ID: 506 115 4711
Passcode: LAMU

19/04/2023

Thursdays! Virtual Clinical Educational Grand Round is on with the Faculty of Medicine.
Topic: Alcoholic Cardiomyopathy, 20th April, 2023, 12hrs Thursday on Zoom.

Alcoholic Cardiomyopathy (ACM) is a cardiac disease caused by chronic alcohol consumption, highlighted by ventricular dilation and impairment in cardiac function. This can be further described by heart failure (both systolic and diastolic), increased left ventricular mass and dilated left ventricle. ACM represents one of the leading causes of non-ischemic dilated cardiomyopathy.

The Q&A session is open for your participation. Grand rounds are a platform for you to learn and interact with your colleagues and professors.

Zoom link:
https://us06web.zoom.us/j/5061154711?pwd=dG9CcTRCRTkrOURTbGZib2YrSzZuQT09

Meeting ID: 506 115 4711
Passcode: LAMU

05/04/2023

Thursdays! Virtual Clinical Educational Grand Round is on with the Faculty of Medicine and Surgery.

Topic: Decompensated Anaemia in a Sickle Cell Disease Patient, 6th April, 2023, 12hrs Thursday on Zoom.

The Q&A session is open for your participation. Grand rounds are a platform for you to learn and interact with your colleagues and professors.

Zoom link
https://us06web.zoom.us/j/5061154711?pwd=dG9CcTRCRTkrOURTbGZib2YrSzZuQT09

Meeting ID: 506 115 4711
Passcode: LAMU

31/03/2023

Fridays! Virtual Clinical Educational Grand Round is on with the Faculty of Nursing and Midwifery.

Topic: Congestive Cardiac Failure, 31st March, 2023, 12hrs Friday on Zoom.

The Q&A session is open for your participation. Grand rounds are a platform for you to learn and interact with your colleagues and professors.

Zoom link
https://us06web.zoom.us/j/5061154711?pwd=dG9CcTRCRTkrOURTbGZib2YrSzZuQT09

Meeting ID: 506 115 4711
Passcode: LAMU

21/03/2023

Everywhere you go take a smile with you 😊

21/03/2023

Have a productive day 😊

20/03/2023

From our INBOX 👇

My advise is that there is always another chance
Let get back to the paper work and go via once more
Will surely make it

20/03/2023

604 COG

258 Made it
Let's try again once more

20/03/2023

COGs Let's get back to the drawing board we need to work twice as hard

Numbers don't lie
Every second that beats leads us to the next Lex exam