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are you sad? Flashcards

1
Q

What characterizes a manic episode?

A

Abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy for at least one week, with three or more symptoms such as inflated self-esteem or grandiosity, decreased need for sleep, and marked impairment in functioning.

Symptoms may also include a need for hospitalization to avoid harm to self or others and/or the presence of psychotic features.

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2
Q

What is the duration required for a hypomanic episode?

A

At least four consecutive days.

Symptoms must not cause marked impairment in functioning or require hospitalization and do not include psychotic features.

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3
Q

What are the key symptoms of a major depressive episode?

A

Five or more characteristic symptoms including depressed mood or loss of interest or pleasure in most or all activities lasting at least two weeks.

Symptoms must cause significant distress and/or impaired functioning.

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4
Q

What are the types of bipolar disorders?

A
  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder
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5
Q

What is required for the diagnosis of bipolar I disorder?

A

At least one manic episode that may or may not be preceded or followed by major depressive or hypomanic episodes.

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6
Q

What is required for the diagnosis of bipolar II disorder?

A

At least one hypomanic episode and at least one major depressive episode.

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7
Q

What characterizes cyclothymic disorder?

A

Numerous periods of hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods of depressive symptoms that do not meet criteria for a major depressive episode.

Minimum duration is two years for adults or one year for children and adolescents.

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8
Q

What factors are linked to the etiology of bipolar disorder?

A
  • Heredity
  • Neurotransmitter abnormalities
  • Brain abnormalities
  • Circadian rhythm irregularities
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9
Q

What is the concordance rate for monozygotic twins regarding bipolar disorder?

A

Concordance rates of .67 to 1.0.

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10
Q

Which neurotransmitters are linked to bipolar disorder?

A
  • Norepinephrine
  • Serotonin
  • Dopamine
  • Glutamate
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11
Q

What brain areas are associated with abnormalities in bipolar disorder?

A
  • Prefrontal cortex
  • Amygdala
  • Hippocampus
  • Basal ganglia
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12
Q

What symptoms help distinguish between bipolar I disorder and ADHD in children?

A
  • Elation
  • Grandiosity
  • Flight of ideas/racing thoughts
  • Decreased need for sleep
  • Hypersexuality
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13
Q

What characterizes manic episodes in adults compared to ADHD?

A

Manic episodes typically feature euphoric mood, increased self-esteem or grandiosity, and distractibility caused by thought acceleration, while ADHD is characterized by a labile mood and distractibility due to wandering thoughts.

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14
Q

What is the typical treatment approach for bipolar disorder?

A

A combination of psychosocial interventions and pharmacotherapy.

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15
Q

What are evidence-based psychosocial interventions for bipolar disorder?

A
  • Psychoeducation
  • Interpersonal and social rhythm therapy
  • Cognitive-behavior therapy
  • Family-focused therapy
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16
Q

What medication is most effective for classic bipolar disorder?

A

Lithium.

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17
Q

What medications are most effective for atypical bipolar disorder?

A
  • Anticonvulsant drugs (e.g., carbamazepine, valproic acid)
  • Second generation antipsychotic drugs
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18
Q

What distinguishes classic bipolar disorder from atypical bipolar disorder?

A

Classic bipolar disorder has a low likelihood of mixed mood states and rapid cycling, while atypical bipolar disorder features mixed mood states and rapid cycling.

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19
Q

True or False: The DSM-5-TR categorization includes classic and atypical bipolar disorder.

A

False.

DSM-5-TR provides the specifier ‘with atypical features’ for bipolar disorder.

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20
Q

What are the three types of depressive disorders?

A

Major depressive disorder, persistent depressive disorder, disruptive mood dysregulation disorder

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21
Q

What is required for the diagnosis of major depressive disorder?

A

Five or more symptoms of a major depressive episode for at least two weeks with at least one symptom being depressed mood or loss of interest or pleasure in most or all activities

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22
Q

What is the duration requirement for persistent depressive disorder in adults?

A

At least two years

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23
Q

What are two or more characteristic symptoms of persistent depressive disorder?

A
  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Feelings of hopelessness
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24
Q

What are the criteria for diagnosing disruptive mood dysregulation disorder?

A

Presence for at least 12 months of (a) severe and recurrent temper outbursts occurring three or more times each week and (b) a persistently irritable or angry mood observable to others most of the day and nearly every day

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25
Q

What are the specifiers for major depressive disorder in DSM-5-TR?

A
  • With peripartum onset
  • With seasonal pattern
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26
Q

What does the specifier with peripartum onset indicate?

A

Onset of symptoms occurs during pregnancy or the four weeks after delivery

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27
Q

What percentage of women experience ‘baby blues’ after childbirth?

A

Up to 80%

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28
Q

What are some evidence-based psychotherapies for peripartum depression?

A
  • Cognitive-behavioral therapy
  • Interpersonal therapy
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29
Q

Which antidepressant is noted as effective for peripartum depression?

A

Sertraline

30
Q

What factors must be considered before prescribing antidepressants to pregnant women?

A
  • Potential negative effects for the developing fetus
  • Impact of untreated maternal depression on mother and child
31
Q

What role does exercise play in the treatment of peripartum depression?

A

Reduces symptoms, but studies show inconsistent results regarding the magnitude of its effects

32
Q

What is seasonal affective disorder (SAD) associated with?

A

A temporal relationship between mood episodes and time of year, usually winter

33
Q

What are common symptoms of seasonal affective disorder?

A
  • Hypersomnia
  • Overeating
  • Weight gain
  • Craving for carbohydrates
34
Q

What hormonal levels are linked to seasonal affective disorder?

A
  • Lower-than-normal serotonin
  • Higher-than-normal melatonin
35
Q

What treatment is often effective for seasonal affective disorder?

A

Phototherapy

36
Q

How do depression rates in childhood compare between boys and girls?

A

Similar rates

37
Q

What happens to the rate of depression in females during early adolescence?

A

It increases

38
Q

What is the ratio of depression rates between females and males in adolescents and adults?

A

1.5 to 3 times higher in females

39
Q

Fill in the blank: The diagnosis of _______ requires a depressed mood with two or more characteristic symptoms for at least two years in adults.

A

Persistent depressive disorder

40
Q

True or False: The rates of depression in childhood are higher in boys than in girls.

A

False

41
Q

What are the key factors linked to the etiology of Major Depressive Disorder?

A

Heredity, neurotransmitter abnormalities, hormone abnormalities, brain abnormalities, cognitive factors, behavioral factors

Major depressive disorder has multiple contributing factors, including genetic components and brain function discrepancies.

42
Q

What did Strakowski and Nelson (2015) find regarding concordance rates for unipolar depression in twins?

A

Monozygotic twins: .30 to .50; Dizygotic twins: .20 to .30

These concordance rates suggest a genetic predisposition for unipolar depression.

43
Q

Which neurotransmitters are found to be related to depression?

A

Serotonin, dopamine, norepinephrine

Low levels of these neurotransmitters are associated with depressive symptoms.

44
Q

What role does the hypothalamic-pituitary-adrenal (HPA) axis play in depression?

A

Regulates body’s reaction to stress; chronic stress leads to hyperactivity and hypersecretion of cortisol

This dysregulation increases the risk for depression, especially with early-life stress.

45
Q

Which brain areas are linked to structural and functional abnormalities in depression?

A

Prefrontal cortex, cingulate cortex, hippocampus, caudate nucleus, putamen, amygdala, thalamus

Neuroimaging studies have identified these areas as being impacted in individuals with depression.

46
Q

What is Lewinsohn’s social reinforcement theory?

A

Depression results from low response-contingent reinforcement for social behaviors

This leads to social isolation and low self-esteem, perpetuating depressive symptoms.

47
Q

What does Seligman’s learned helplessness model propose about depression?

A

Linked to uncontrollable negative life events leading to a sense of helplessness

The model emphasizes the importance of cognitive styles in the experience of depression.

48
Q

What is Beck’s cognitive theory of depression?

A

Depression is attributed to a negative cognitive triad: negative thoughts about oneself, the world, and the future

This theory highlights the importance of cognitive patterns in the development of depressive symptoms.

49
Q

What are the primary risk factors for major depressive disorder in younger adults?

A

Genetics, stressful life events, cognitive limitations

These factors contribute significantly to the onset of depression in younger populations.

50
Q

What is a strong risk factor for major depressive disorder in older adults?

A

Chronic medical illness

Especially when it leads to decreased physical functioning and social isolation.

51
Q

How do older adults typically express symptoms of major depressive disorder compared to younger adults?

A

Older adults refer to somatic symptoms, cognitive changes, loss of interest; younger adults refer to affective symptoms

This difference highlights the importance of age in the expression of depressive symptoms.

52
Q

How do cultural backgrounds influence the experience of major depressive disorder?

A

Non-Western cultures report more somatic symptoms; Western cultures report more psychological symptoms

Cultural context affects how individuals express and perceive depressive symptoms.

53
Q

What is the most common comorbid disorder with major depressive disorder?

A

Substance use disorder (especially alcohol use disorder)

This highlights the significant overlap between depression and substance-related issues.

54
Q

What sleep abnormalities are associated with depression?

A

Prolonged sleep latency, reduced REM latency, reduced slow-wave sleep, increased REM density

These abnormalities can exacerbate depressive symptoms and affect overall health.

55
Q

What medical conditions are commonly linked with depression?

A

Coronary heart disease, stroke, diabetes, Parkinson’s disease

The relationship between these conditions and depression can be bidirectional.

56
Q

True or False: Depression is more common than anxiety in patients after a myocardial infarction.

A

True

Most studies indicate that depression frequently develops following heart attacks.

57
Q

What are the primary treatments for major depressive disorder?

A

Psychotherapy and/or pharmacotherapy

These treatments can be used alone or in combination.

58
Q

What did the meta-analysis find regarding combined treatment for major depressive disorder?

A

Combined treatment was more effective than either psychotherapy alone or pharmacotherapy alone in terms of response and remission rates

No significant differences were found between psychotherapy alone and pharmacotherapy alone.

59
Q

What does APA’s Clinical Practice Guideline recommend for children with depression?

A

Insufficient evidence to recommend any particular psychosocial or pharmacological treatment

This indicates a need for further research in this age group.

60
Q

What treatments does the APA guideline recommend for adolescents?

A
  • Cognitive-behavioral therapy (CBT)
  • Interpersonal psychotherapy for adolescents (IPT-A)
  • Fluoxetine as a first-line medication

There is insufficient evidence to recommend one treatment over another.

61
Q

What initial treatment options are recommended for adults with major depressive disorder?

A
  • Psychotherapy
  • Second-generation antidepressant (SSRI or SNRI)

The guidelines do not favor one treatment over the other.

62
Q

What psychotherapies are recommended for adults in the treatment of depression?

A
  • Cognitive-behavioral therapy (CBT)
  • Mindfulness-based cognitive therapy (MBCT)
  • Interpersonal therapy (IPT)
  • Behavioral therapy
  • Psychodynamic therapy
  • Supportive therapy

All are considered appropriate without preference for one over the others.

63
Q

What does the guideline suggest for older adults with depression?

A
  • Group cognitive-behavioral therapy (group-CBT)
  • Combination of IPT and a second-generation antidepressant

Insufficient evidence for self-guided bibliotherapy or life review therapy.

64
Q

What is St. John’s wort and what are its effects?

A

It has similar therapeutic effects as SSRIs for mild and moderate depression and lower dropout rates with fewer side effects

It is not effective for severe depression and can interact with certain medications.

65
Q

How is ketamine used in treating depression?

A

As a fast-acting treatment for treatment-resistant depression (TRD) and suicidal ideation, prescribed as a nasal spray (esketamine)

It increases glutamate levels and is used with an oral antidepressant.

66
Q

What is electroconvulsive therapy (ECT) and its success rates?

A

High success rate for severe depression with response rates approaching 80% and remission rates around 70%

Typically used when other treatments are ineffective or symptoms are severe.

67
Q

What are the disadvantages of ECT?

A
  • Anterograde amnesia
  • Retrograde amnesia

Anterograde amnesia resolves within weeks; retrograde amnesia may persist longer.

68
Q

What is repetitive transcranial magnetic stimulation (rTMS)?

A

A noninvasive technique using a magnetic field to stimulate the left dorsolateral prefrontal cortex, often for treatment-resistant depression

It has lower response and remission rates than ECT but does not cause memory loss.

69
Q

What were the trends in suicide rates in the United States from 2000 to 2020?

A

Increased from 2000 to 2018, then slightly decreased from 2018 to 2020; consistently higher for males than females

Rates were 3 to 4 times higher for males.

70
Q

In 2020, which demographic had the highest suicide rates?

A

Individuals ages 75 and older and American Indians/Alaska Natives

Followed by Whites, Hispanics, Blacks, and Asians/Pacific Islanders.

71
Q

What age group had the highest suicide rates for males and females in 2020?

A
  • Males: 75 years and older
  • Females: 45 to 64 years

This highlights gender differences in age-related suicide risk.

72
Q

What were the highest suicide rates by race/ethnicity in 2020?

A
  • American Indians/Alaska Natives: ages 25 to 34
  • Hispanics: ages 25 to 34
  • Blacks: ages 25 to 34
  • Whites: ages 45 to 54
  • Asians/Pacific Islanders: ages 85 and older

This illustrates the variation in suicide risk across different demographics.

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