Abnormal Psych Depressive And Bipolar Disorders

Front 1

depressive and bipolar disorders

Back 1

1. pervasive mood disregulation--extreme of normal functioning

2. present across the lifespan--manifestation may be different in children

3. present across cultures, economic status

4. huge costs to individual and society

Front 2

costs for individual and society bc of depression/bipolar

Back 2

1. job loss, missed work

2. divorce/discontent

3. substance use

4. suicide

Front 3

DSM 5 depressive episode

Back 3

1. 5 or more criteria in a 2 week period

3. symptoms cause clinically significant impairment

3. not due to substance use or medical condition

Front 4

DSM 5 criteria for major depression

Back 4

1. depressed mood (emotional)

2. diminished pleasure in activities ( anhedonia, emotional

3. significant weight loss or weight gan (physical)

4. insomnia or hypersomnia nearly every day (physical)

5. psychomotor agitation or retardation nearly every day (behavior)

6. fatigue or loss of energy nearly every day

7. feel worthless or excessive/innapropriate guilt (cognitive)

8. diminished ability to think or concentrate (cog)

9. recurrent thoughts of death, suicidal thoughts or attempts (multiple)

Front 5

DSM 5 manic episode

Back 5

1. distinct period of abnormal mood (at least 1 week)--elevated, expansive, irritable

2. other features

3. significant impairment

Front 6

other features for criteria of manic episode

Back 6

1. inflated self esteem/grandiosity

2. decreased need for sleep

3. pressured speech

4. flight of ideas

5. distractibility

6. increased goal directed activity

7. excessive involvement in pleasurable activities with potential for negative consequences

Front 7

dysthymic episode

Back 7

1. similar symptoms to depression

2. less severe

3. longer duration--at least 2 years

Front 8

hypomanic episode

Back 8

1. persistent elevated mood

2. less severe but similar to mania

3. not severe enough to lead to hospitalization, generally less impairment

Front 9

mixed episode

Back 9

symptoms or mania and depression at the same time

Front 10

DSM 5 depressive and bipolar disorders

Back 10

1. major depressive disorder

2. persistent depressive disorder

3. bipolar I

4. bipolar II

5. cyclothymic disorder

Front 11

major depressive disorder (unipolar)

Back 11

1. at least one major depressive episode

2. no curernt or previous manic or hypomanic episode

Front 12

persisten depressive disorder

Back 12

chronic low grade depressed mood (2+ years)

Front 13

bipolar I

Back 13

1. at least one manic episode

2. nearly all will eventuallly have a major depressive episode

Front 14

bipolar II

Back 14

1. hypomania

2. current or past major depressive episode

Front 15

cyclothymic disorder

Back 15

1. chronic, fluctuating mood disturbance

2. separate periods of hypomanic and depressive symptoms

3. up to half will eventually meet criteria for bipolar I

Front 16

other specifying features of depressive and bipolar disorders

Back 16

1. melacholic features

2. psychotic features

3. peripartum obset/postpartum

4. seasonal pattern

Front 17

melancholic features of depressive and bipolar disorers

Back 17

1. profound depressed mood, despair, little or no pleasure

2. major physical slowing, exhaustion

Front 18

psychotic features and dep. and bipol. disorders

Back 18

1. delusional thinking

2. hallucinations

Front 19

peripartum onset/postpartum depress and bip disorders

Back 19

1. occur first immediately after birth of child

2. often severe with psychotic features

3. very high risk if premorbid mood episode (up to 50x)

4. risk incrases in subsequent births after the first episode

Front 20

seasonal pattern of dep and bip. dis.

Back 20

regular seasonal pattern to episodes

2. full remissions occur at a regular time of year

Front 21

prevalence of major depression

Back 21

1. lifetime prevalence--20%

2. 1 year prevalence--8-10%

3. equal rates in males and females before puberty

4. 2 or 3X more common among women after puberty

Front 22

bipolar I and II prevalence

Back 22

1. lifetime prevalence--3-5%

2. 1 year prevalence--2-3%

3. equal rates in men and women

Front 23

cyclothymic disorder prevalence

Back 23

1. liftime prevalence--1%

2. 1 year prevalence--<1%

3. equal rates in men and women

Front 24

depressive and bipolar diosrders and impairment

Back 24

1. academic functioning

2. social functioning

3. occupational functioning

4. life functioning

Front 25

dep and bi academic impairment

Back 25

1. lower grades

2. higher rates of dropped classes, drop out of school

Front 26

dep and bi social impairment

Back 26

1. friendships, romantic relationships

2. parenting

Front 27

dep and bi occupational impairment

Back 27

among the top five causes of lost wages/productivity

Front 28

dep and bi life impairment

Back 28

1. driving impairment

2. exercise less

3. poor money management

4. suicide--as high as 10-20%

Front 29

course of depressive and bipol

Back 29

1. onset

2. developmental precursors

3. clinical course

4. rapid cycling depressive or bipolar disorder

Front 30

onset of depressive and bi dis

Back 30

1. wide range from childhood through 50's

2. average--early 20's, getting younger

Front 31

developmental precursors of depressive and bi

Back 31

low level symptoms are present for years before the first episode

severe stress often precedes onset (not required for diagnoses)

Front 32

clinical course of depression and bip

Back 32

1. spontaneous recovery between episodes

2. very rare to have single episode

3. each subsequent episode is typically more severe

Front 33

rapid cycling depressive or bipolar disorder

Back 33

4 or more episodes per year

90% female

Front 34

brain correlates of major depressive disorder

Back 34

1. structural and functional MRI--executive control system underactive, amygdala hyperactivity, hippocampus size and activity reduce

2. different levels of neurotransmitters and stress hormones

Front 35

neurotransmitters and stress hormones difference major dep

Back 35

1. stress response--elevated cortisol, lowered immune response

2. low serotonin--neuromodulator; low levels may decrease regulation of other neurotransmitters, permit wider range

3. low norepinephrine

4. complex dysfunction across multiple systems

Front 36

structural and functional MRI differences in bipolar I

Back 36

1. increased activity in entire brain during mania, especially amygdala

2. hypersensitive to reward

3. relative prefrontal cortex underactivation (dramatic during depressive phase)

Front 37

neurotrasmitters and stress hormone differences in bi. I

Back 37

1. elevated cortisol (stress hormone)

2. deplete serotonin--neuromodulator loses ability to regulate other neurotransmitter systems

3. norepinephrine, dopamine elevated (esp in manic state)

4. GABA involved (link to anxiety/agitation)

Front 38

MDD: environmental risk and protective factors

Back 38

1. diathesis-stress--interaction with genetic risk

2. loss events

3. chronic stress

4. social support

Front 39

complication between risk factors or consequences

Back 39

1. stressors are a clear risk factor for relapse

2. low social support is a risk factor for depression

3. depression also leads to a decline in social support

Front 40

mdd loss events

Back 40

specific to depression and not anxiety

2. divorce or other end of relationship--key risk factor

Front 41

mdd chronic stress

Back 41

may play a rold in comorbidity of mdd and anxiety

key contributor to relapse

Front 42

mdd social support

Back 42

protective factor that is often lost when depression hits

Front 43

bipolar disorder environmental risk and protective factors

Back 43

1. similar to MDD

2. expressed emotion in the family (key for relapse)

3. substance use

Front 44

bipolar envorn. risk factors similar to mdd

Back 44

1. diathesis-stress--interaction with genetic risk

2. loss events

3. chronic stress

4. social support

Front 45

bip enviro risk expressed emotion in the the family

Back 45

1. high levels of anger/distress

2. intrusive

Front 46

bi enviro risk substance use

Back 46

1. may precipitate

2. important consequence

3. risk for relapse