â– LECTURE OVERVIEW: Major Depressive Disorder (MDD) is a common, debilitating mood disorder diagnosed biochemically by meeting specific clinical criteria outlined in the DSM-5.
â– THE SIGECAPS CRITERIA:
1. Diagnostic threshold: Requires at least 5 of 9 symptoms present during the same 2-week period, representing a change from previous functioning, where at least one symptom must be depressed mood or anhedonia (loss of interest/pleasure).
2. The mnemonic:
- S - Sleep disturbances (insomnia or hypersomnia).
- I - Interest loss (profound anhedonia).
- G - Guilt or feelings of worthlessness.
- E - Energy depletion or fatigue.
- C - Concentration difficulties or indecisiveness.
- A - Appetite and weight changes (increase or decrease).
- P - Psychomotor agitation or retardation.
- S - Suicidal ideation or recurrent thoughts of death.
â– PROFESSOR'S ADVANCED PATHOPHYSIOLOGY:
The cellular cascade undergoes active remodeling in response to sustained stressors. Intracellular signalling involves key phosphorylation tracks and secondary lipid messengers, culminating in altered gene transcription and structural adaptations in target tissues.
â– CLINICAL REGISTRY INSIGHTS:
Patient registry reviews depict high clinical validity in diverse populations, indicating highly correlated trends of symptom development and treatment responsiveness.
[HY-BOARD-1001]
🌟 Dynamic Clinical Key:
First-line pharmacological treatment is selective serotonin reuptake inhibitors (SSRIs; e.g., Sertraline, Escitalopram). Sexual dysfunction and weight gain are the most common reasons for treatment non-adherence and discontinuation. Assess patient clearance profiles (creatinine clearance and LFTs) before starting multi-drug regimens to avoid severe toxic accumulation. Assess demographic representation when applying trial results to real-world patients.