Ch. 6 - Mood disorders Flashcards

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1
Q

% worldwide

A

8%

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2
Q

Mood disorder demographics

A
  1. Gender
  2. Relationship
  3. Age
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3
Q

gender

A

women > men

- women internalize depression, men externalize depression

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4
Q

Relationship

A

single women < single men

married women > married men

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5
Q

single women < single men

married women > married men

A
  1. social standards, men are protectors, need wife
  2. women are homemakers
  3. married men turn to spouse for support, single women have greater support (feel isolated when married)
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6
Q

Age

A

women: 20-29 (spikes in teens
Men: 40 - 49 and old age
Infants: separation

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7
Q

rumination disorder

A

babies regurgitate food and eat again

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8
Q

Major depressive disorder symptoms

A

(must be recurrent)

  • 5 or more symptoms in 2 weeks
    1. Mood sx
    2. Cognitive sx
    3. Motivational sx
    4. motor and somatic sx
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9
Q

how many episodes to have recurrent major depressive disorder

A

2 or more episodes in a 2 month interval (ppl who have had depression are more likely to have recurrent)

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10
Q

MDD Mood Sx

A

sad, crying, numbness, helplessness, hopeless

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11
Q

MDD Cognitive Sx

A

low self-esteem, unrealistic guilt, exaggerate seriousness, delusions, memory problems, indecisive, decrease concentration

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12
Q

ex. MDD cognitive sx

A

worrying that kid will be homeless bc of 1 D on exam > blame themselves

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13
Q

MDD Motivational Sx

A

anhedonia - loss of interest, social ideation

typical pattern: take long time to fall asleep, wake up early and can’t go back to sleep

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14
Q

MDD Motor and somatic sx

A

appetite disturbance, sleep disturbance, fatigue, headaches, nausea

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15
Q

2nd to schizophrenia in hospital admits

A

major depression

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16
Q

What increases probability of recurrence of episodes

A

number of previous episodes

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17
Q

Beck Depression Inventory (BDI)

A

quick screening/assessment

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18
Q

Depressive sx in children

A

somatic problems, irritability, social withdraw, school problems

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19
Q

ex. of somatic in children

A

stomach aches

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20
Q

ex of school probs in children

A

low grades, fights

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21
Q

symptoms of MDD in elderly

A

memory loss, distractibility (mimics dementia)

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22
Q

Types of Major Depression

A
  1. Post-Partum
  2. Seasonal Affective Disorder (SAD)
  3. Dysthymia
  4. Mania and Bipolar Disorder
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23
Q

Post-Partum depression

A

onset w/in 4 weeks after birth

  • affects 10-15% mothers
  • NOT baby blues
  • 28% still affected 1 yr later
  • 5% still affected 4 yrs later
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24
Q

Post-Partum risk factors

A
  1. previous depression
  2. poor/no relationship with partner
  3. weak social support
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25
Q

Post-Partum cause

A

abnormal prenatal hormones

- mothers may not initially feel anything for child (no connection)

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26
Q

Seasonal Affective Disorder (SAD)

A

fall/winter

increase in appetite and sleep

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27
Q

cause of SAD

A

serotonin deficiencies in winter

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28
Q

treatment of SAD

A

light therapy, antidepressants

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29
Q

Dysthymia

A

chronic, mild depression for 2-20 yrs

Criteria: need 2 symptoms of major depression in past 2 years

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30
Q

Double depression

A

dysthymia + major depression

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31
Q

Mania and Bipolar disorder, symptoms

A

elevated/irritable mood, hyperacctivity, excessive talkativeness, flight of ideas, inflated self-esteem, high distractibility, sleeplessness, involvement in activities w/ painful consequences

32
Q

ex. of involvement in activities w/ painful consequences

A

shopping when you have a lack of money

33
Q

how often must you exhibit mania symptoms to have disorder

A

must exhibit 3 or more symptoms in 1 week

- must be abnormal for the person

34
Q

inflated self-esteem

A

delusionsn (false beliefs) ex. thinking you can fly

35
Q

sleeplessness

A

lack of sleep but still active

36
Q

Manic episode criteria

A
  1. 3 or more symptoms for one week and one of the following:
    - significant impact in occupation/social function
    - need hospitalized to prevent harm
    - presence of psychotic features
37
Q

Hypomanic episode

A
  • 3 or more symptoms for 4 days
  • doesnt exhibit the sig. impact, need for hospitalization, or psychotic features
  • less severe, not severe enough to become threat to someone else or hospitalization
38
Q

Types of Manic Disorders

A
  1. Mania
  2. Bipolar I Disorder
  3. Bipolar II Disorder
  4. Cyclothymia
39
Q

Bipolar I Disorder

A

mania w/ major depression
- can have all
symptoms of major depression
- often begins late adolescence w/ manic episode
- commonly doesn’t exhibit major depression symptoms prior to 1st manic episode

40
Q

Bipolar II Disorder

A
  • involves episodes of hypomania w/ major depression

- rather than mania, ppl often seek treatment for depressive symptoms

41
Q

Cyclothymia

A
  • depression and mania are less severe than Bipolar I/II

- usually 2 yr duration

42
Q

more bipolar info

A
  • rapid cycling: poorer prognosis
  • median age of onset: 25
    higher among SES groups
  • Bipolar I: no sex difference
  • Bipolar II greater in females
43
Q

causes of bipolar disorder

A
  1. heredity
  2. neurotransmitters
  3. role of stress
44
Q

Bipolar causes: heredity

A

MZ twins: 40% likely both have disorder
DZ twins: 5-10 % likely
- you are likely to have another family member with a mood disorder (higher genetic component)

45
Q

Bipolar causes: neurotransmitters

A

many ppl with bipolar disorder have low serotonin and high norepinephrine (clinical challenge to treat both)

46
Q

Bipolar causes: stress

A

can precipitate manic episodes

- children are more likely to develop when parent has frequent episodes

47
Q

Treatment of Bipolar Disorder

A
  • use mood stabilizers
    1. Lithium
    2. Anticonvulsants
    3. Antipsychotics
    All work by changing activity within the receiving neuron
48
Q

why aren’t antidepressants used to treat bipolar disorder

A

antidepressants can bring on a manic episode

49
Q

Lithium

A

treats mania and depression

  • slows dopamine and norepinephrine
  • increases serotonin
50
Q

problems with lithium

A

weight gain, tremors

51
Q

Anticonvulsants problems

A

weight gain, drowsiness

52
Q

Theories of depression

A
  1. cognitive theory
  2. learned helplessness
  3. learning model
  4. biological model
53
Q

depression: cognitive theory

A

irrational, illogical beliefs lead to depression

  1. arbitrary inference
  2. selective abstraction
  3. magnification and minimization
54
Q

arbitrary inference

A

conclusions from insufficient evidence

ex. friend blows you off without strong explanation, believe they don’t like you anymore

55
Q

selective abstraction

A

focus on insignificant detail and ignore the important

ex. get report card and focus on one C+ instead of all other B’s

56
Q

magnification and minimization

A

small bad events blow up, minimize larger good events

ex. ignoring an A on an exam

57
Q

Learned helplessness

A
  • perception that behavior has no effect on our experience
  • inescapable (ex. can’t leave relationship/job)
  • hopelessness often occurs
58
Q

Learning model

A

over-reinforcement of depressed behavior and under-reinforcement of non-depressive behavior

59
Q

Biological model

A

neurotransmitter imbalance

- faulty transmission of norepinephrine and serotonin (not enough is getting through)

60
Q

Treatment for Depression

A
  1. antidepressant medication
  2. ECT
  3. Talk Therapies
  4. Psychedelic therapy
61
Q

antidepressant medication

A
  1. tricyclics
  2. MAO inhibitors
  3. SSRI’s
62
Q

Tricyclics

A

act on reuptake of norepinephrine and serotonin (slow down reuptake process and get more nor and ser through to post synaptic neuron)

63
Q

side effects of tricyclics

A

“anticholinergic effects”: dry mouth, blur vission, disrupt sexual function
“cardiotoxic”: high risk of overdose

64
Q

MAO inhibitors

A

stop MAO enzyme, used for atypical symptoms

- would have to watch diet and avoid foods that increase blood pressure

65
Q

MAO

A

tends to degrade transmitters we want

- need MAO bc it helps control blood pressure

66
Q

SSRI (selective serotonin reuptake inhibitors

A
  • fewer side effects
67
Q

SNRI (selective serotonin and norepinephrine reuptake

A

used for both ser and nor

  • stops reuptake of ser and nor
  • fewer side effects: sleep probs, headaches, sexual probs
68
Q

Why did the FDA require warnings on SSRI’s

A

effects motivation before mood so depressed people who were previously unmotivated to harm themselves may now have the motivation

69
Q

ECT (electroconvulsive shock treatment)

A

now a valid treatment for severe depression unresponsive to meds
- given 70-130 volts, 6-12 treatments over 1 month
side effects: temporary memory loss, confusion

70
Q

Talk Therapies

A
  1. interpersonal therapy
  2. behavioral therapy
  3. cognitive therapy
71
Q

interpersonal therapy

A

short term, focus on problems people have in relationships, boundaries, self-esteem

72
Q

behavioral therapy

A

helping people display non-depressed symptoms

- focus on social skills training and assertiveness

73
Q

Cognitive therapy

A

teach clients to be own therapist, replace irrational beliefs with rational beliefs

74
Q

Psychedelic therapy

A

involves use of MDMA to treat depression, anxiety, and ptsd

- guided therapeutic session using psychedelics (discuss feelings with drug induced sense of openness and warmth

75
Q

most effective treatment for depression

A

cognative therapy and antidepressants combined