Chapter 4 - Mood Disorders and Suicide Flashcards
1
Q
Emotion definition?
A
- Complex reaction patterns involving experience, behaviour, and physiological reaction
- Physiological reactions are often very similar among various emotions, so context of the experience is very important
2
Q
Mood definition?
A
- Normal moods are considered a short-lived emotional state
- Those with mental disorders may be more disposed to respond emotionally to things (more emphasis on moods)
- Ex. depression is a type of mood
3
Q
Affect definition?
A
- A more general, global term for moods and emotions
- Can have affects that are positive, negative, or flat
4
Q
Euphoria vs. dysphoria?
A
- Euphoria - a state of extreme happiness and well-being
- Dysphoria - a state of extreme unhappiness and feeling low
5
Q
What are the two types of unipolar mood disorders?
A
- Unipolar depression (MDD)
- Unipolar mania (this is very rare)
6
Q
What are the two types of bipolar disorder?
A
- BP1 - Episodes of depression and mania. DOn’t have to have a depressive episode to be diagnosed, more emphasis on manic episodes.
- BP2 - Episodes of depression and hypomania. This form is more cyclical than BP1
7
Q
What are some of the distinct differences between sadness and depression?
A
- Sadness - Usually temporary, you know you’re sad
- Depression - Persistent, can occur without precipitating events, often out of proportion with life events, impaired ability to function, wide variety of symptoms
8
Q
What are some of the emotional symptoms of unipolar depression?
A
- Dysphoric mood
- Despondency
- Despair (high suicide risk)
- 1/3 - 2/3 experience anxiety
9
Q
What’s mood lability?
A
- Rapid mood changes that may be found in those in a manic state
10
Q
What are some of the cognitive symptoms of unipolar depression?
A
- SLowed thinking, poor concentration
- Feelings of guilt, worthlessness
- Beck’s depressive triad - focus on negative aspects of self, environment, future
- Suicidal ideation behaviour
11
Q
What’s anhedonia?
A
- The inability to experience pleasure
- A somatic symptom of those dealing with unipolar depression
12
Q
What is required for an individual to be diagnosed with unipolar depression?
A
- The experience of at least one major depressive episode of at least a 2-week duration, without any manic episodes
- Symptoms must include either depressed mood or markedly diminished interest or pleasure
- 5 or more symptoms in total are needed for diagnosis
13
Q
What’s Persistent Depressive Disorder (Dysthymia)?
A
- Chronic low mood for at least 2 years with at least 2 associated symptoms
- Can be accompanied by recurrent episodes of MDD
- Has higher levels of impairment, a younger age of onset, higher rates of comorbidity, a stronger family history of psychiatric disorders, lower social support, higher stress, more dysfunctional personality traits
14
Q
What is required to be diagnosed with bipolar 2?
A
- One or more hypomanic episodes with one or more major depressive episodes
15
Q
What’s cyclothymia?
A
- Chronic mood swings over at least 2 years, numerous hypomanic and depressive episodes that do not meet criteria for MDD
- Not severe enough to meet criteria for bipolar disorder
- More rapid cycling of mood states
16
Q
What does the term mixed states refer to?
A
- When an individual with bipolar experiences both manic/hypomanic and depressive symptoms
17
Q
What’s Seasonal Affective Disorder (SAD)?
A
- More depressed during the winter (less light)
- Can co-occur with MDD
- may be caused by phase-delay in the circadian rhythm
- Artificial sunlight/nature helps
18
Q
What’s a mood disorder with peri- or post-partum onset?
A
- A mood disorder often caused by extreme hormone fluctuations that set in during the last few weeks of pregnancy
- Mood changes during pregnancy are normal, but extreme cases may arise and lead to mood disorders
19
Q
What are the common course and outcomes of unipolar depressive disorder?
A
- Onset early in life (early to mid-twenties)
- Average duration of a depressive episode is 6-9 months
- A frequently poorly diagnosed, chronic and recurrent condition if left untreated
- High comorbidity with anxiety
20
Q
What are the common course and outcomes of bipolar disorder?
A
- Mean onset age is 20 years, although many report before 17
- Average hypomanic/manic episodes last 2 weeks to 4 months, while depressive episodes can last 6-9 months
- Most patients will have more than one episode before diagnosis
- Intervals between episodes vary
- 40-50% of patients achieve sustained recovery with treatments
21
Q
What are some epidemiological facts regarding mood disorders?
A
- 5-10% of the population meet the criteria for mood disorders within the previous 12 months
- 5 unipolar: 1 bipolar
- Women are more likely to experience depression than men
- Young people more susceptible than older people for mood disorders
22
Q
What are some of the psychosocial factors that can contribute to the development of mood disorders?
A
- Attachment and loss
- Stressful life events
- The stress generation hypothesis: people who have depression generate negative social events which maintain depressive symptoms
- Aversive patterns of emotional expression within a family
- Self-verification theory: negative feedback-seeking
- Interpersonal dependency and excessive reassurance seeking
- History of stressful life events
23
Q
What are some of the psychological factors that can contribute to the development of mood disorders?
A
- Cognitive distortions
- Depressive schema (core beliefs about the self, the world, and the future)
- Feelings of helplessness and hopelessness
- Reduced levels of activity, less positive reinforcement
- Rumination
- Personality factors
24
Q
What are some of the biological factors that contribute to the development of mood disorders?
A
- People with first-degree relatives with MDD are 2-5 times more likely to get MDD, while for bipolar it’s 7-15 times more likely
- Interaction of severe life stress and genetics
- Sleep and circadian functioning
- Neurotransmitters and the density and sensitivity of post-synaptic receptors
- Neuroendocrine system and HPA aixs (mediates stress response)
- Structural and functional brain abnormalities
25
What is the most common treatment for unipolar depression?
- Cognitive therapy
26
What are other forms of treatment for unipolar depression?
- Interpersonal therapy (more emphasis on relationships)
- Antidepressant medications
- Transcranial magnetic stimulation, vagus nerve stimulation, phototherapy for SAD
- For severe cases: ECT
27
What are the different types of antidepressant medications used for unipolar depression?
- Tricyclics (1960s)
- Selective serotonin reuptake inhibitors
- Monoamine oxidase (MAO) inhibitors
28
What are the types of treatments available for those with bipolar?
- Lithium carbonate (not used very often due to the harsh side effects)
- Anticonvulsant medication (more common, may cause drowsiness)
- Psychotherapy helps with social and self-management skills
- ECT may be used for severe cases
29
T/F: 30% of all suicides are related to mental disorders.
- FALSE, it's 50%
- 15-20% of people with mental disorders will eventually commit suicide
30
What's the difference between suicidal ideation and a suicidal gesture?
- Ideation - thinking of suicide, suicidal ideas that are never brought into action
- Gesture - commit an act that presents a certain danger. Signifies a cry for help
31
How many attempted suicides per year happen in Canada?
- 10-20 million
32
T/F: Men are more likely to commit suicide than women
- TRUE
33
T/F: Suicide is the second-highest cause of death after car accidents among males aged 15-19
- TRUE
34
Which demographic is most likely to complete a successful suicide?
- Men aged 40-54, and older men (>75)
35
T/F: Aboriginals have a suicide risk 5 times more likely than the general population.
- FALSE
- It's 2-4 times more likely
36
What's Joiner's Interpersonal model concerning the etiology of suicide?
- Individual has a high level of perceived burdensomeness and feelings of alienation, and hopelessness about the future leads to ideation and intent
- Repeated ideation, self-harm (increase pain tolerance), and suicide attempts reduce fear of death
- Completed suicides become more likely
37
What's O'Connor's Integrated Motivational Volitional Model concerning the etiology of suicide?
- Stress is accompanied by thoughts of defeat, humiliation, and entrapment
- Feelings of being thwarted, a sense of being burdened increase
38
Is it true that restrictive firearm policies help reduce the amount of completed suicides?
- TRUE
39
What are some of the treatments for suicide prevention?
- Primary prevention (main goal)
- Crisis lines
- Psychotherapy
- Treating the underlying problem
- Hospitalization, voluntary or involuntary
40
What depressive disorder is often referred to as the "common cold" of mental disorders?
- Major Depressive Disorder
41
T/F: Bipolar 2 is often harder to diagnose than bipolar 1
- TRUE because hypomanic episodes are not as severe as manic episodes
42
Are individuals with cyclothymia at risk for developing full-blown bipolar disorder?
- yes
43
How does the DSM-5 define rapid cycling in bipolar disorder?
- The presence of 4 or more manic and/or major depressive episodes in a 12-month period
- Rapid cycling may be induced by antidepressants
44
Ultrarapid vs. ultradian cycling?
- Ultrarapid - cycling every few days
- Ultradian - cycling that occurs daily
45
Where is peri- and post-partum depression most common?
- In countries with higher levels of income inequality, maternal and infant mortality, or childbearing-age-women working more than 40 hours a week.
46
What are two major personality models that are used to describe etiology in mood disorders?
- The Five Factor Model
- The Behavioural Inhibition System/Behavioural Activation System (BIS/BAS) (punishment system/reward system)
47
What's the goal of CBT as a treatment for unipolar depression?
- The goal is for the therapist to use Socratic-type questions and guided discovery to help clients make their own insights into their thought processes
48
What are some common interventions used in CBT?
- Thought records - allows client to identify their negative thought patterns
- Behavioural experiments - the client tries them out to test their negative beliefs
- Activity scheduling
49
What is family-focused therapy (FFT) often used for?
- Used for educating the patient and their family members about bipolar disorder
50
What's the purpose of interpersonal and social rhythm therapy?
- Used with bipolar patients and teaches them how to regulate their routines and provides skills on how to manage stressful life events
51
How does lithium work as a treatment for bipolar disorder?
- Don't fully know
- Believe it reduces the transmission of excitatory neurotransmitters, especially dopamine and glutamate
52
What's another term for a suicidal gesture?
- A parasuicide
53
What's the strongest risk factor for dying by suicide?
- Being a man
54
What are the two most frequently diagnosed mental disorders in victims of suicide?
1) Mood disorders
2) alcohol and substance abuse
55
What's the most effective prevention strategy for suicide?
- Restricting access to suicide means
56
T/F: Just treating depression with standard antidepressants or CBT is enough to reduce suicide ideation and attempts.
- FALSE
- There is a form of CBT specifically meant to prevent suicide attempts
