Dr.  Ahmad  AlHadi   Assistant  Professor,  Consultant  of  Psychiatry  and  Psychotherapy   Department  of  Psychiatry,  College  of  Medicine   King  Saud  University   Riyadh,  Saudi  Arabia Agenda   •  IntroducCon   •  Depression   •  CBT   •  CBT  for  Depression   •  Behavioral  acCvaCon   •  Summary  &  feedback Needs  Assessment   •  What  do  you  want  from  this  workshop   (CBT  for  Depression)? Objec0ves:   •  AMendants  of  this  workshop  will:   1.  Know  the  basic  concept  of  CBT.   2.  Know  the  CBT  techniques.   3.  Learn  how  CBT  can  be  used  in  treatment  of   Depression. Why  Depression?   •  The  2nd  leading  cause  for  disability  now   •  The  1st  in  2020   •  Chronic   •  Common Exercise   •  Write  down  as  much  as  you  can  of  Depression   symptoms  and  signs  in  one  minute. Major  Depressive  Disorder   DSM5  Diagnos0c  Criteria   A.  Five  (or  more)of  the  following  symptoms  have  been  present  during  the   same  2-­‐week  period  and  represent  a  change  from  previous  func0oning:  at   least  one  of  the  symptoms  is  either  (1)  depressed  mood  or  (2)  loss  of   interest  or  pleasure.  Note:  Do  not  include  symptoms  that  are  clearly   aNributable  to  another  medical  condi0on.   1.  Depressed  mood  most  of  the  day,  nearly  every  day,  as  indicated  by   either  subjec0ve  report  (e.g.,  feels  sad,  empty,  hopeless)  or   observa0on  made  by  others  (e.g.,  appears  tearful).  (Note:  In  children   and  adolescents,  can  be  irritable  mood.)   2.  Markedly  diminished  interest  or  pleasure  in  all,  or  almost  all,  ac0vi0es   most  of  the  day,  nearly  every  day  (as  indicated  by  either  subjec0ve   account  or  observa0on).   3.  Significant  weight  loss  when  not  die0ng  or  weight  gain  (e.g.,  a  change   of  more  than  5%  of  body  weight  in  a  month),  or  decrease  or  increase  in   appe0te  nearly  every  day.  (Note:  In  children,  consider  failure  to  make   expected  weight  gain.)     4.  Insomnia  or  hypersomnia  nearly  every  day. Major  Depressive  Disorder   DSM5  Diagnos0c  Criteria   5.  Psychomotor  agita0on  or  retarda0on  nearly  every  day  (observable  by  others,   not  merely  subjec0ve  feelings  of  restlessness  or  being  slowed  down).     6.  Fa0gue  or  loss  of  energy  nearly  every  day.     7.  Feelings  of  worthlessness  or  excessive  or  inappropriate  guilt  (which  may  be   delusional)  nearly  every  day  (not  merely  self-­‐reproach  or  guilt  about  being   sick).     8.  Diminished  ability  to  think  or  concentrate,  or  indecisiveness,  nearly  every  day   (either  by  subjec0ve  account  or  as  observed  by  others).   9.  Recurrent  thoughts  of  death  (not  just  fear  of  dying),  recurrent  suicidal  idea0on   with-­‐  out  a  specific  plan,  or  a  suicide  aNempt  or  a  specific  plan  for  commi[ng   suicide.     B.  The  symptoms  cause  clinically  significant  distress  or  impairment  in  social,   occupa0onal,  or  other  important  areas  of  func0oning.     C.  The  episode  is  not  aNributable  to  the  physiological  effects  of  a  substance  or  to   another  medical  condi0on. Major  Depressive  Disorder   DSM5  Diagnos0c  Criteria   Note:  Criteria  A-­‐C  represent  a  major  depressive  episode.     D.  The  occurrence  of  the  major  depressive  episode  is  not   beMer  explained  by  schizoaffecCve  disorder,  schizophrenia,   schizophreniform  disorder,  delusional  disorder,  or  other   specified  and  unspecified  schizophrenia  spectrum  and  other   psychoCc  disorders.     E.  There  has  never  been  a  manic  episode  or  a  hypomanic   episode.  Note:  This  exclusion  does  not  apply  if  all  of  the   manic-­‐like  or  hypomanic-­‐like  episodes  are  substance-­‐induced   or  are  aMributable  to  the  physiological  effects  of  another   medical  condiCon. Diagnosis   •  one  or  more  Major  Depressive  Episode .   DSM-­‐IV-­‐TR  diagnosCc  criteria:   A.  At  least  5  of  the  following,  during  the  same  2-­‐week  period,  represenCng   a  change  from  previous  funcConing;  must  include  either  (a)  or  (b):     1.  Depressed  mood   2.  Diminished  interest  or  pleasure   3.  Significant  weight  loss  or  gain  (AppeCte)   4.  Insomnia  or  hypersomnia  (sleep)   5.  Psychomotor  agitaCon  or  retardaCon  (acCvity)   6.  FaCgue  or  loss  of  energy   7.  Feelings  of  worthlessness  (guilt)   8.  Diminished  ability  to  think  or  concentrate;  indecisiveness   9.  Recurrent  thoughts  of  death,  suicidal  ideaCon,  suicide  aMempt,  or  specific   plan  for  suicide