Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSYC3102 > 5 - Bipolar and Depressive Disorders > Flashcards

5 - Bipolar and Depressive Disorders Flashcards

1
Q

Which disorder is attributed to be the leading cause of disability worldwide?

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Compare the prevalence rates of unipolar and bipolar disorder across genders?

A

Unipolar more prevalent in females (2:1 ratio); equal prevalence for bipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

There are no race or SES distinctions for mood disorders. What is the typical onset age for more than half of individuals?

A

Before age of 25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is bipolar disorder defined in diagnosis?

A

According to most recent episode (manic, depressed or hypomanic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the manic symptoms for bipolar 1 disorder

A

Euphoria; grandiosity; pressured speech; impulsivity; excessive libido; recklessness; social intrusiveness; diminished need for sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What specifiers can be used in describing bipolar 1?

A

Manic, hypermanic, depressed or unspecified; severity: mild, moderate or severe; with psychotic features; partial or full remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some additional features of bipolar 1 disorder?

A

Anxious distress; mixed features; melancholic features; atypical features; catatonia; peripartum onset (in relation to pregnancy or childbirth); seasonal pattern; rapid cycling; psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In the diagnostic criteria of a manic episode, A is a distinct period of abnormally and persistently elevated, expansive or irritable mood and goal-directed activity or energy for at least 1 week. Criteria B must include 3 or more of which symptoms?

A

Inflated self esteem/grandiosity; decreased need for sleep; increased speech, talkativeness or pressure of speech; flight of ideas or racing thoughts; distractibility (reported/observed); increased goal-directed activities or psychomotor agitation; excessive involvement in pleasurable activities with high potential for painful consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe criteria C and D of a manic episode

A

C. Marked impairment in functioning, or need hospitalisation, or psychotic features; D. Not due to effects of substances or another medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hypomanic episode meets most of the criteria for manic episode but isn’t as severe. What are the main features?

A

Lasts for only 4 consecutive days; associated with uncharacteristic change in functioning; observable to others; not severe enough to cause impaired social or occupational functioning, or hospitalisation, and no psychotic features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In a major depressive episode, 5 or more symptoms must be present during the same 2 week period and represent change from previous functioning. What may these symptoms include?

A

Depressed mood; diminished interest/pleasure; significant weight loss; insomnia/hypersomnia; psychomotor retardation; fatigue; feelings of worthlessness/inappropriate guilt; diminished concentration/indecisiveness; recurrent thoughts of death/suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

At least one of which 2 symptoms must be present to be diagnosed with major depressive disorder?

A

Depressed mood or loss of interest/pleasure (anhedonia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is bipolar II distinct from bipolar I?

A

One or more major depressive episodes are accompanied by at least one hypomanic episode, but never had a manic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe cyclothymic disorder

A

Mild form of bipolar; at least a 2 yr period (1 for children) of hypomanic and depressive symptoms but don’t reach episodes (or fulfill criteria); not without symptoms for 2 months in the 2 yr period; insidious onset in late teens or early 20s; female to male ratio of 3:2; less than 1% lifetime prevalence; a third develop a major mood disorder (bipolar I)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What kind of medical disorders and drug use are common differential diagnoses for bipolar?

A

Medical: Epilepsy; Huntington’s chorea; multiple sclerosis; traumatic brain injury; HIV/AIDS; Drugs: amphetamines; cocaine; hallucinogens; opiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some other psychiatric disorders of special consideration for manic symptoms?

A

Schizophrenia; borderline, narcissistic and histrionic personality disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which symptom does bipolar often start with?

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most people experience both depression and mania, with only a minority experiencing manic episodes alone. With more chronic cases, what often decreases?

A

The amount of time between episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Compare prognosis for bipolar with depressive disorders, and describe the indicators of a good prognosis

A

Worse prognosis for bipolar; those with pure manic symptoms do better than those with mixed or depressed symptoms; Good prognosis indicators: short duration of manic episodes; oder onset age; few suicidal thoughts; few co-existing psychiatric/medical problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which kind of disorder shows higher divorce rates and suicidal behaviour?

A

Bipolar (over unipolar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Persistent depressive disorder is the low grade form of depressive disorders, and must be present for at least 2 yrs (1 in children). The presence of 2 or more of which symptoms must be present while depressed?

A

Poor appetite/overeating; insomnia/hypersomnia; low energy/fatigue; low self-esteem; poor concentration/indecisiveness; feelings of hopelessness (not without symptoms for a 2 month period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Although major depressive disorder may be present for 2 yrs when diagnosed with persistent depressive disorder, what disorders are excluded?

A

Never had manic episode, hypomanic or cyclothymic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the suicide risk for mood disorders?

A

30 times more risk than general population (15% for uni and bipolar); 2/3 of clinically depressed contemplate suicide; increase in youth and decrease for older people (15-24 age range, mostly men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

List common differential (secondary) diagnoses for major depressive disorder

A

Neurological problems (PD; dementing illness; epilepsy; stroke; tumours, etc); pharmacological agents (illicit/prescription drugs); other psychiatric disorders (e.g. bipolar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does depression frequently coexist with?

A

Eating disorders; personality disorders; schizophrenia; alcohol/drug abuse; anxiety disorders (major probability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Both anxiety and depression share underlying dimensions of negative affect. What distinguishes the two?

A

Anxiety: anxious arousal; Depression: low positive affect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

5-10% of people with an initial diagnosis of major depression have a manic episode how long after their first episode of depression?

A

6-10 years

28
Q

What can withdrawal of antidepressants before 3 months lead to?

A

Relapse

29
Q

MDD is fundamentally a cyclic disorder. What can increase the risk of recurrence?

A

History of more than 1 previous depressive episode; co–existence with dysthymia, alcohol/drug abuse, or anxiety symptoms

30
Q

How does the Life Events Perspective explain the aetiology of depression, and what’s a problem with this view?

A

It highlights events involving loss; EE is linked to relapse; but environmental precipitants are not always identified, and it’s not just the events but how we deal with it that mediates the effects

31
Q

How does the Life Events Perspective explain the aetiology of bipolar?

A

Life events precede episodes (e.g. schedule disrupting events/goal attainment events - not able to regulate); attributional styles and dysfunctional attitudes interact with intervening life events; family discord predicts poor short-term outcomes

32
Q

How does the Psychodynamic view explain the aetiology of depression?

A

It’s a reaction to the loss of an unconsciously/ambivalently held object (whereas grief/mourning is consciously perceived loss); reflects internalised aggressive impulses; high dependency needs predisposes people to a depressive reaction; but no empirical support that anger is turned inward

33
Q

According to Lewinsohn (1975), depression occurs as a result of a reduction in response-contingent positive reinforcement. When may this reduction occur?

A

When the probability that the individual’s behaviour will be followed by reinforcement is low; or the probability that the individual will be reinforced when they don’t emit the behaviour is high (poor correspondence between what they do and what’s reinforced)

34
Q

According to the Reduced Positive Reinforcement view, in which 3 ways may insufficient reinforcement occur?

A

Environment produces a loss of reinforcement; lack of requisite skills; unable to enjoy or receive satisfaction from reinforcement

35
Q

How do cognitive theories propose the cause of depression?

A

Event occurs > belief > consequence; it’s not what happens to us, but how we perceive it

36
Q

The Learned Helplessness model by Seligman proposes that attributions we make vary along several dimensions: personal/universal; global/specific; stable/unstable. Depressive symptoms are more likely to occur when we make which attributions about aversive events?

A

Personal; stable; and global (e.g. “I failed the test because I’m totally hopeless with any sort of test situation”); this leads to a sense of helplessness and an expectation that desirable outcomes will not occur > depression

37
Q

Describe Beck’s Negative triad model

A

A person has a negative view of self, world and future > negative schemata or belief (triggered by negative life events > cognitive biases (e.g. arbitrary inference) > depression

38
Q

What does the Interpersonal Theory focus on in depression and bipolar?

A

Role of social support in health; suggest people with depression have fewer and less supportive social networks; social skills deficits (problem-solving skills; marital communication); bipolar: low social support associated with longer episodes

39
Q

What does the pedigree model propose about the genetic contribution of mood disorders?

A

Higher frequency of mood disorders among relatives of bipolar probands that unipolar depressed; 50-60% of those with bipolar have a family history of the disorder; higher frequency of depression among relatives of depression probands than among relatives of control families

40
Q

According to the classical twin design, does bipolar or depression have a higher heritability estimate?

A

Bipolar (80%; depression closer to schizophrenia 52%)); higher in MZ twins for both; There are also polygenic influences (not 1 specific gene)

41
Q

What does the Catecholamine hypothesis propose about neurochemical abnormalities?

A

Excess (especially noradrenaline) causes mania and too little cause depression (Lithium has been shown to reduce noradrenaline activity at key neural sites)

42
Q

What does the Indolamine hypotheses propose about neurochemical abnormalities?

A

Deficiency in serotonin also related to depression; some antidepressants increase serotonin levels

43
Q

What are some limitations with the neurochemical perspective?

A

There are complex inter-relationship between neurotransmitters and other biological systems which preclude a simple deficit model; a simple biochemical deficit/excess model can’t account for a heterogeneous disorder like depression, which involves a dysregulation of many functions

44
Q

What are the four categories of antidepressants, and other than the many side effects, what else may they provoke?

A

SSRIs (most frequently used); Tricyclics (TCAs; Monoamine oxidase inhibitors (MAO-Is); other more recently developed drugs; Can provoke an episode of mania in bipolar patients

45
Q

Although electro-convulsive therapy (ECT) as primary treatment has declined because of the dangers, when is it still used?

A

When: prominent psychotic/melancholic features; severe depression doesn’t respond to medication; severe life-threatening situations require rapid response (e.g. suicidal); prior clinical response to ECT positive

46
Q

What is lithium used to treat, and how effective is it?

A

Manic episodes and cyclothymia (60% respond well); alleviates manic episodes for some and depressive episodes; maintained use between episodes - less likely to relapse; about 57% non-compliance rate

47
Q

What are some of the side effects of lithium

A

Weight gain; transient nausea; trembling; weakness; impaired coordination; memory problems; drinking and passing lots of water; serum levels need to be monitored

48
Q

Describe the role of psychological treatment in relation to bipolar disorder

A

Lack of controlled blind clinical trials; some studies report negative results; interventions often show efficacy in terms of the psychosocial consequences; but less definite results in terms of medication compliance and relapse; relapse prevention seems to be most effectively gained via medication compliance

49
Q

Which 3 approaches in combination seem to have the most efficacy in treating depression?

A

CBT, interpersonal relationship therapy (IPR -focuses on social skills and relationships), and medication

50
Q

In the treatment of depression collaborative research program, which treatments had the greatest efficacy on a long term basis?

A

All three treatments were equally effective short-term: medication, CBT and IPR; but at 18 month follow up, none of the groups differed from the placebo group; more than 70% relapse rate

51
Q

What symptoms is seasonal affective disorder characterised by?

A

Somatic symptoms, such as overeating; carbohydrate craving; weight gain; fatigue; sleeping more than usual

52
Q

In what way does the evolutionary perspective claim that the symptoms of depression may serve a useful purpose?

A

Symptoms (e.g. slowing down; withdrawal, etc) may represent a response system that helps the person disengage from a situation that’s not going well, or help refocus motivations

53
Q

Some evidence suggests that depression is more likely to occur when severe life events are associated with what kind of feelings?

A

Humiliation; entrapment; and defeat

54
Q

Describe the phenomenon Stress Generation

A

When depressed people create difficult circumstances that increase the level of stress in their lives (especially in the context of interpersonal relationships)

55
Q

What are the hypotheses concerning Ruminative response styles and Distracting styles?

A

People who engage in ruminative responses (turning attention inwards) have longer and more severe episodes of depression than people who engage in distracting responses; women are more likely to engage in ruminating and men more likely to employ distracting styles

56
Q

People who are homozygous for which allele in which gene, are at a particularly high risk for becoming clinically depressed if they experience stressful life events?

A

S allele of the 5-HTT gene

57
Q

Which important pathway in the endocrine system may be closely related to the aetiology of mood disorders?

A

Hypothalamic-pituitary-adrenal (HPA) axis

58
Q

People who take a test dose of Dexamethasone show a suppression of cortisol secretion, as the hypothalamus is fooled into thinking there’s enough cortisol circulating in the system. How do some people with depression respond to this?

A

Approx. half show a failure of suppression in response to DST (overproduction of cortisol may lead to changes in brain structure and function)

59
Q

Depressed patients with decreased activity in the dlPFC may show what kinds of deficits?

A

Planning that’s guided by the anticipation of emotion, leading to motivational problems, such as an inability to work towards a pleasurable goal

60
Q

Overactivity in the orbital PFC and vmPFC may be associated with what kinds of deficits?

A

In the ability to inhibit inappropriate behaviours and assign emotional meaning to perceptions, leading to a prolonged experience of negative emotion

61
Q

When laboratory animals are exposed to uncontrollable stress from which they can’t escape, what kind of behaviour do they exhibit?

A

Symptoms similar to those seen in depressed humans

62
Q

Monoamine Oxidase inhibitors (MAOIs) have been found to be useful in treating depressed patients, and certain anxiety disorders such as agoraphobia and panic attacks, as long as they avoid what?

A

Foods such as cheese, beer and red wine

63
Q

Rather than descriptive factors, what are classification systems for suicide based on?

A

Causal theories

64
Q

What are the four different types of suicide identified by Durkheim, which are distinguished by social circumstances?

A

Egoistic (diminished integration – detachment from society); altruistic (excessive integration – sacrifice for the sake of others); Anomic (diminished regulation – adjusting to unexpected loss of social/occupational role); fatalistic (excessive regulation – unbearable life circumstances)

65
Q

What’s the most commonly reported mechanism for eliciting self-injurious behaviour?

A

A maladaptive way of regulating intense emotional states (anxiety, anger, frustration or sadness)

66
Q

What did Dirkheim believe to be the reason for increased suicide rates during the 19th century?

A

An erosion of the influence of traditional sources of social integration and regulation, such as the church and family

67
Q

What special recommendations are considered particularly important in psychological interventions when clients have expressed a serious intent to harm themselves?

A

Reduce lethality (reduce psychological pain and means to commit suicide); negotiate agreements (sign a contract); provide support (involve friends and family); replace tunnel vision with a broader perspective (help them develop more flexible, adaptive patterns)

PSYC3102 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions