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cp: 1.2 mood (affective) disorders: depressive disorder (unipolar) and bipolar disorder > 1.2.3 Treatment and management of mood (affective) disorders > Flashcards

1.2.3 Treatment and management of mood (affective) disorders Flashcards

1
Q

Drug therapy

Lithium

A

Malhi et al. (2013) noted Lithium has been used for 50+ years as an effective treatment.

Works well as stablising manic moods, but doesn’t affect depression much.

It possesses anti-suicidal properties that no other drug has achieved.

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2
Q

Drug therapy

Side effects of Lithium

A
  • Drowsiness
  • Hand tremors
  • Dry mouth, increased thirst/urination
  • Nauseau, vomiting, appetite loss
  • Stomach pain
  • Impotence, loss of interest in sex
  • Feeling uneasy
  • Changes in skin/hair
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3
Q

Drug therapy

Paliperidone

A

Joshi et al. (2013) noted Paliperidone was effective in treating acute bipolar disorder in children/adolescents after an 8-week randomised trial where all ppts took the drug.

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4
Q

Drug therapy

Side effects of Paliperidone

A

Significant weight gain (average 4.1lbs).

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5
Q

Drug therapy

Olanzapine

A

Katagiri et al. (2013) conducted a study to test the efficacy/safety of using olanzapine for bipolar disorder.

In the drug group, patients showed greater improvement in symptoms across a range of questionnaires, however, they also showed greater weight gain and a rise in cholesterol.

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6
Q

Unipolar - Biological treatments

Tricyclics

A

A class of medications that are used primarily as anti-depressants.

They were first discovered in the early 1950s and were marketed later in the decade.

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7
Q

Unipolar - Biological treatments

Side effects of tricyclics

A
  • Dry mouth
  • Dry nose
  • Blurry vision
  • Constipation
  • Cognitive/memory impairment
  • Increased body temperature
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8
Q

Biological treatments

Monoamine oxide inhibitors (MAOIs)

A

The first class of antidepressants to be developed.

Stopped being used due to concerns about interactions with certain foods and numerous drug interactions.

They elevate levels of norepinephrine, serotonin and dopamine by inhibiting an enzyme called monoamine oxidase.

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9
Q

Biological treatments

Side effects of MAOIs

A
  • Dry mouth
  • Hypertension
  • Lethal with some foods!
  • Nauseau, diarrhoea or constipation
  • Headache
  • Drowsiness
  • Insomnia
  • Dizzy/lightheadedness
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10
Q

Biological treatments

Selective serotonin reuptake (SSRIs)

A

A class of drugs that are** typically used as anti-depressants in the treatment of major depressive disorder and anxiety disorders**.

These are the newest anti-depressants.

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11
Q

Biological treatments

Side effects of SSRIs

A

Increased suicidal thoughts.

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12
Q

Biological treatments

What did Rucci et al. (2011) find out about the effectiveness of SSRIs on reducing suicidal thoughts?

A

SSRIs may reduce suicidal thoughts in people with major depression.

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13
Q

Biological treatments

What did Nordenskold et al. (2013) find out about the effectiveness of using ECT with drug therapy alone?

A

In the group of ppts with drug therapy, 61% relapsed within a year, compared to 32% of patients who had ECT + drug therapy.

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14
Q

Biological treatments

Strengths of drugs

A
  • Alleviates symptoms
  • Has saved many lives and helped normal functioning
  • More useful for moderate/severe depression
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15
Q

Biological treatments

Criticisms of drugs

A
  • Don’t cure illness
  • Side effects
  • Cause dependency
  • Take time to work
  • Less useful for mild depression
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16
Q

Biological treatments

Strengths of ECT

A
  • Has saved lives.
17
Q

Biological treatments

Criticisms of ECT

A
  • Ethical issues
  • Needs repetition since effects don’t last
  • Causes memory loss/headaches etc.
18
Q

CBT - Cognitive/behavioural treatments

CBT

A

Therapist and patient talk to try and identify illogical thinking via questioning.

19
Q

CBT - Cognitive/behavioural treatments

Reality testing (cognitive restructuring)

A

This therapy explains the cognitive theory of depression to the patient and teaches them to understand that their way of reasoning about themselves contributes to their depression.

Hence, they are trained to recognise/record their thoughts.

Such thoughts are explore/challenged in therapy sessions.

Therapist then used techniques to ‘reattribute’ the problems and failures of the patient and get them to reframe their thinking about each situation.

20
Q

CBT - Cognitive/behavioural treatments

What did Wiles et al. (2013) show about CBT and depression?

A

Cognitive restructuring can reduce symptoms of depression in people who did not respond to drug therapy.

21
Q

CBT - Cognitive/behavioural treatments

According to Beck, what should CBT be guided by?

A

The cognitive triad of automatic negative thoughts (about the self, future and the world), faulty info processing and negative self-schemas.

22
Q

CBT - Cognitive/behavioural treatments

How does cognitive restructuring work, using Beck’s ‘Cognitive Triad’ approach?

A
  1. Therapist explains the rationale behind the therapy.
  2. Patient is taught how to monitor automatic negative thoughts and self-schemas.
  3. Patient taught behavioural techniques to challenge negative thoughts.
  4. Therapist and patients explore how negative thoughts are responded to by the patient.
  5. Dysfunctional beliefs are identified/challenged.
  6. Therapy ends with patients having the ‘cognitive tools’ to repeat the process by themselves.
23
Q

CBT - Cognitive/behavioural treatments

Strengths of Beck’s ‘Cognitive Triad’ approach

A
  • Scientific = experiments can be designed to test hypotheses derived from this theory.
  • Has supporting evidence, e.g. Grazioli and Terry.
24
Q

CBT - Cognitive/behavioural treatments

Criticisms of Beck’s ‘Cognitive Triad’ approach

A
  • Overly deterministic = some people may exercise freewill and regain control of automatic thinking through therapy/coaching.
  • Cannot explain all aspects of depression = hallucinations, anger etc., patients may get frustrated their symptoms cannot be explained according to this theory and therefore cannot be addressed in the therapy.
25
Q

CBT - Cognitive/behavioural treatments

What did Hans and Hiller (2013) find about outpatient CBT for depression?

A

Their meta-analysis found outpatient CBT was effective in reducing depressive symptoms and these were maintained at least 6 months after the CBT ended.

26
Q

REBT (Ellis, 1962) - Cognitive/behavioural treatments

What did Ellis state about rationality and irrationality?

A

Rationality consists of thinking in ways that allow us to reach our goals; irrationality consists of thinking in ways that prevent us from reaching our goals.

27
Q

REBT (Ellis, 1962) - Cognitive/behavioural treatments

ABC model

A
  • Activating event: this is a fact, behaviour, attitude or an event.
  • Beliefs: the person holds beliefs about the activating event.
  • Cognitive: this is the person’s cognitive response to the activating event as well as emotion.
28
Q

REBT (Ellis, 1962) - Cognitive/behavioural treatments

Example of ABC model

A
  • A = failing an exam
  • B = I am a failure or I hate failing an exam
  • C = depression
29
Q

REBT (Ellis, 1962) - Cognitive/behavioural treatments

Strengths of Ellis’ ABC model

A
  • Useful = provides a practical application in CBT.
30
Q

REBT (Ellis, 1962) - Cognitive/behavioural treatments

Criticisms of Ellis’ ABC model

A
  • Cannot explain all types/aspects of depression = many suffer from depression without an apparent cause and may feel frustrated their concerns aren’t reflected in this theory.
31
Q

REBT & CBT - Cognitive/behavioural treatments

What did Szentagotai et al. (2008) find about the effectiveness of REBT, CBT and drug therapy for treating a major depressive episode?

A

In terms of 3 main depressive thoughts, all 3 treatments appeared to decrease these immediately, post treatment and then at follow-up.

32
Q

REBT & CBT - Cognitive/behavioural treatments

Why did Sava et al. (2008) find REBT and CBT to be better treatments that drug therapy?

A

They are more cost-effective.

33
Q

Issues and debates

Do these treatments for mood (affective) disorders support individual explanations or situational?

A

Most these treatments look at individual factors, since some people benefit from drugs whilst other prefer CBT etc., but there are other situational factors that could trigger depression, like job loss, which aren’t considered.

34
Q

Issues and debates

Does the cognitive explanation favour the nature or nurture side of the debate?

A

The cognitive explanation favours the nurture side since it points to dysfunctional patterns of behaviour and thinking that are learnt via our interactions with the world.

Therefore, it also recognises situational factors, with the treatments reflecting these standpoints.

cp: 1.2 mood (affective) disorders: depressive disorder (unipolar) and bipolar disorder (3 decks)

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