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64 Cards in this Set
- Front
- Back
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What were mood disorders called prior to the DSM-IV?
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-Depressive Disorders
-Affective Disorders -Depressive Neuroses |
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Major Depressive Episode
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2 WEEK MINIMUM
Most common and severe experience of depression including: -feelings of worthlessness -disturbances in bodily activities such as sleep -loss of interest -inability to experience pleasure -persisting at least 2 weeks. |
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What are the 4 major types of depressive disorders, as noted in lecture?
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Ready?
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4 Major Types of Depressive Disorders
Type 1 |
Major Depressive Dissorder
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4 Major Types of Depressive Disorders
Type 2 |
Dysthymic Disorder
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4 Major Types of Depressive Disorders
Type 3 |
Double Depression
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4 Major Types of Depressive Disorders
Type 4 |
Depressive Disorder Not Otherwise Specified
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What are the major types of Bipolar Disorders?
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Ready?
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Major Types of Bipolar Disorders
Type 1 |
Bipolar 1 Disorder
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Major Types of Bipolar Disorders
Type 2 |
Bipolar 2 Disorder
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Major Types of Bipolar Disorders
Type 3 |
Cyclothymic Disorder
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Major Types of Bipolar Disorders
Type 4 |
Bipolar Disorder Not Otherwise Specified
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How many of the depressive symptoms must be met to meet criteria for a Major Depressive Episode?
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5 or more symptoms during the same 2-week period
(with at least one of the symptoms being of a depressed mood or a loss of interest or pleasure) |
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What are the two types of a Major Depressive Disorder? How do they differ?
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Major Depressive Disorder:
1. Single Episode 2. Recurrent Episode If its a single episode (which is very rare), there has never been a manic episode, a mixed episode, or a hypomanic episode. |
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What are the defining features of Dysthymia?
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AT LEAST 2 YEARS
2 OR MORE SYMPTOMS Depressed mood for most of the day, more days than not, as indicated by subjective account of observation, for at least 2 years Presence, while depressed, of 2 (or more) of the following: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness |
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What children’s character was associated with Dysthymia?
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Eeyore from Winnie the Pooh
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Double Depression
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Severe mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder.
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Defining Features of Manic Episodes
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AT LEAST 1 WEEK
3 OR MORE* * 4 if mood is only irratable A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). During the period of mood disturbance, 3 (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been preset to a significant degree: Inflated self-esteem or grandiosity Decreased need for sleep (rested after 3 hours of sleep) More talkative than usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing Distractibility Increase in goal directed activity or psychomotor agitation Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., buying sprees, sex, foolish investments) Symptoms do not meet criteria for a mixed episode Impairment in functioning, relationships, may need hospitalization Not due to substances or GMC |
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Defining Features of Mixed Episodes
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The criteria are met both for Manic Episode and for a Major Depressive Episode (except duration) nearly every day during at least a 1-week period.
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. The symptoms are not due to the direct physiological effects of a substances or a GMC |
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Defining Features of Hypomanic Episodes
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AT LEAST 4 DAYS
3 OR MORE SYMPTOMS* A distinct period of persistently elevated, expansive or irritable mood, lasting throughout at least 4 days, clearly different from the usual nondepressed mood During the period of mood disturbance, 3 (or more) of the following symptoms have persisted (four if mood is only irritable) and have been present to a significant degree: Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing Distractibility Increase in goal-directed activity or psychomotor agitation Excessive involvement in pleasurable activities that have a high potential for painful consequences Episode associated with an unequivocal change in functioning uncharacteristic of the person when not symptomatic Disturbance in mood and change in functioning is observable by others. Not severe enough to cause marked impairment in functioning or necessitate hospitalization, no psychotic features Not due to a substance or GMC |
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Six Different Types of Bipolar 1 Disorder
Type 1 |
Most Recent Episode Hypomanic
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Six Different Types of Bipolar 1 Disorder
Type 2 |
Most Recent Episode Manic
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Six Different Types of Bipolar 1 Disorder
Type 3 |
Most Recent Episode Mixed
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Six Different Types of Bipolar 1 Disorder
Type 4 |
Most Recent Episode Depressed
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Six Different Types of Bipolar 1 Disorder
Type 5 |
Most Recent Episode Unspecified
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Six Different Types of Bipolar 1 Disorder
Type 6 |
Single Manic Episode (describes first episode of mania)
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What type of onset Dysthymia is associated with worse prognosis and chronicity?
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Early onset dysthymia has a worse prognosis than late onset dysthymia.
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Bipolar 1 Vs. Bipolar 2
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Bipolar 1: Alternating between major depressive and manic episodes
Bipolar 2: Alternating major depressive and HYPOMANIC episodes |
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What percentage of Bipolar 1 Progress to Bipolar 2?
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10-13%
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Cyclothymia
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Chronic (at least 2 years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes.
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How does Cyclothymic disorder differ from bipolar disorder?
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Cyclothymia is a more chronic version of Bipolar with episodes that are less severe.
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What are the defining features of cyclothymic disorder?
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For at least 2 years they present with numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet the criteria for a Major Depressive Diosrder.
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Be able to differentiate between the six symptom specifiers of Mood Disorders
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Ready?
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Mood Disorder Symptom Specifier 1
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Atypical
-weight gain -can react with interest or pleasure -associated more with women and and earlier age of onset -more symptoms, more severe, more suicide attempts, and higher rate of cormorbid disorders |
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Mood Disorder Symptom Specifier 2
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Melancholic
-Applies only if the full criteria for a major depressive episode have been met (does not apply in case of dysthemia) -more severe somatic symptoms such as early morning awakenings, weight loss, loss of libido, excessive or inappropriate guilt, and anhedonia |
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Mood Disorder Symptom Specifier 3
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Chronic
-applies only of the full criteria for a major depressive episode have been met continously for at least the past 2 years (which eliminates dysthymic disorder). |
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Mood Disorder Symptom Specifier 4
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Catatonic
This specifier can be applied to major depressive disorders and even to manic episodes, though it is very rare, and rarer still in mania. -Absence of movement, or excessive and random movement |
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Mood Disorder Symptom Specifier 5
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Psychotic
-Some individuals in the midst of a major depressive or manic episode may experience psychotic symptoms, specifically hallucinations and delusions |
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Mood Disorder Symptom Specifier 6
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Postpartum onset specifier
-Can apply to both major depressive and manic episodes -early recognition important to protect the mother and child |
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3 Course Specifiers for Mood Disorders
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Ready?
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Course Specifier for Mood Disorder 1
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Longitudinal Course Specifier
-Whether the person currently suffering from an episode has had major episodes of depression or mania in the past is important, as is whether the person fully recovered between episodes -if the person has had dysthemia or cyclothymia helps determine the course of the current episode |
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Course Specifier for Mood Disorder
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Rapid Cycling Specifier
-applies only to bipolar 1 and 2 -movement between manic and depressive episodes -if someone experiences 4 manic or depressive episodes within a year is considered to have a rapid-cycling pattern -people who rapid cycle are at higher risk for suicide |
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Course Specifier for Mood Disorder 3
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Seasonal Pattern Specifier
-applies to bipolar and recurrent major depressive disorder -occurs during certain seasons |
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Worldwide prevalence for Major Depression
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16.1%
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Worldwide prevalence for Dysthymia
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3.6%
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Worldwide prevalence for Bipolar
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1.3%
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Depressive Attributional Style 1:
Internal Attributions |
negative outcomes are one's own fault
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Depressive Attributional Style 2: Stable Attributions
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Believing future negative outcomes will be one's own fault
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Depressive Attributional Style 3: Global Attribution
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believing negative events disrupt many life activities
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To what is the gender imbalance in mood disorders at least partly attributable to?
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Socialization
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4 Different Types of Antidepressants to treat Depressive Disorders
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Ready?
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Antidepressant 1
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Tryciclic Medications
-widely used -ex. tofranil, elavil -block reuptake of norepinephrine and other neurotransmitters -takes 2-8 weeeks to take effect -negative side effects are common -may be lethal in excessive doses |
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Antidepressant 2
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Monoamine Oxidase (MOA) Inhibitors
-enzyme that breaks down seratonin/norepinephrine -block monoamine oxidase -slightly more effective than tryciclics must avoid certain foods |
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Antidepressant 3
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Selective Serotonergic Re-uptake Inhibitors (SSRIs)
-specifically block reuptake of seratonin -floxetine (prozac) is the most popular SSRI -negative side effects are common |
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Antidepressant 4
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Lithium
-primary drug of choice for bipolar -side effects may be severe -dosage must be carefully monitered -how lithium works remains unclear -a type of salt |
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ECT (Electro-shock Therapy)
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-involves applying brief electrical current to the brain
-results in temporary seizures -6-10 treatments needed -effective for severe depression -side effects include short term memory loss |
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TMS
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Transcranial Magnetic Stimulation
alters electrical activity in the brain a new alternative to ECT |
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What Psychological Approaches where used in treatment?
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Cognitive Therapy: addresses cognitive errors in thinking, and includes behavioral components
Behavioral Activation: involves increased contact with reinforced events Interpersonal Psychotherapy: FOcuses on problamatic interpersonal relationships outcomes are comparable to medications |
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Where does suicide fall on the top ten leading causes of death in the US?
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8th leading cause of death
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Which ethnicities most often attempt and commit suicide?
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-Whites and Native Americans
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Why do more men commit but more women attempt?
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more women than men are depressed, and suicide is tied to depression
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What are the risk factors for suicide?
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-suicide in family
-low seratonin levels -evidence of preexisting psychological disorder -alcohol use or abuse -past suicide behavior -experiencing a shameful/humiliating stressor -publicity about suicide or media coverage |
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What does publicity do to suicide rates?
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Increases suicides
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What is a psychological autopsy?
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a method of identifying risk factors of suicide in which friends and family of the deceased are interviewed to put together a profile of those who are at risk for suicide
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