chapter 5 Flashcards

1
Q

What can be the definition of mood?

A

Temporary mindset that can influence how we understand and process situations

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

What are the symptoms that must be present for Major Depressive Disorder and how long should they persist?

A

Needed:
- Severely low mood AND/OR characterized by anhedonia
- must persist for minimum of two weeks

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

What was the change in DSM 5 in regards to major depressive disorder?

A

Elimination of “bereavement exclusion”
- previous depressive symptoms stemming from grief wouldn’t have been deemed MDD
- Controversy - including grief may medicalize mourning and lead to over treatment

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

What are several important diagnoses related to mood?

A
  • depressive disorders
  • disruptive mood dysregulation disorder
    -BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the symptoms of Persistent Depressive Disorder?

A
  • severely low mood AND/OR anhedonia
  • diagnosis requires presence of fewer symptoms than MDD
  • must last at least two years
  • less intense than MDD but longer term
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Premenstrual Dysphoric Disorder and its critiques?

A
  • new to DSM5
  • changes in mood, irritability, appetite change during luteal phase of menstrual cycle
  • distinguished from PMS by severity of symptoms and increased impact of daily functioning
  • critique - over medicalizing a natural biological process and stigmatizing female bodies/minds
  • coincides with extension of a patent for existing med for new use intended to treat PMDD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Disruptive Mood Dysregulation Disorder and its controversy?

A
  • new to DSM 5
  • exclusively applied to children 6-18
  • extreme anger or irritability that seems disproportional to the triggering situation
  • critique - medicalizes normal phases of emotional development
  • majority diagnosed also match symptoms of oppositional defiant disorder
  • children likely to be treated with antipsychotic meds
  • labelling children with mental illness affects how they see the would and themselves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Bipolar Disorder?

A
  • Episodes of mania and depression
  • mania - distinct periods of abnormally and persistently elevated, expansive or irritable mood and abnormal and persistent increased goal directed activity or energy at least a week
  • …. may engage in compulsive and potentially harmful activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hypomania and how it differs from mania?

A

Milder form of mania - elevated mood with lesser degrees of functional impairment
- less need for sleep, higher energy, self-confidence, overly optimistic
- mania = more severe, may involve psychosis, more likely to lead to incarceration or hospitalization, treatment may differ

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

What are the 3 subtypes of Bipolar?

A

Bipolar 1 - Mania and depression (depression not necessary for diagnosis)
Bipolar 2 - Hypomania and more severe depression (stronger depressive symptoms, less intense mania)
Cyclothymic disorder - most mild form with swings between mild depression and hypomania

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

What is Euthymia

A

periods without mania or depression

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

What are the different treatments for mood disorders?

A
  • psychotherapy (CBT)
    -Psychopharmaceuticals
  • ECT when other treatments fail
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What did Kirsch find about antidepressants and the placebo effect

A
  • using SSRIs for the treatment of MDD… 50% was genuine placebo effect
  • Analysis of all available data suggests placebo effect accounts for 80% of patient response
  • drug manufacturers bury negative findings and bias…
  • insufficient evidence in favour of prescribing SSRIs
  • recommend psychotherapy, exercise, acupuncture for same benefit with lower risk of side effects
  • relapse rates higher in ADMs than other treatments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does Iatrogenic mean?

A

they cause side effects that could lead to disease

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

What is the continuation phase?

A

the period of time between when meds would be effective and the depressive episode would have resolved on its own -> suggesting “better” to stay on meds

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

What does spontaneously remit mean?

A

Even without treatment, it may go away on its own

17
Q

What was case study two?

A

Put patients on either placebo, ADM, or CBT…after treatment ended people who did well on CBT were less likely to relapse than those who did well on ADM
- CBT had more enduring positive results, reduced risk of relapse
- use of meds -> reduces enduring effectiveness of CBT

18
Q

In case study two how do antidepressants work?

A
  • do not increase overall level of serotonin in the brain, short term reallocation within the brain happens (more in cells, less out cells) but total level stays the same
  • cause long term overall decline in pool of serotonin, full consequences not yet completely known
19
Q

Why would a psychiatrist treat depression with ADM when psychotherapy works well?

A
  • need to invest a lot of time in psychotherapy
  • access problem with health insurance for psychotherapy
  • long waitlists for psychotherapy
  • ADMS cost less than psychotherapy
  • RCT results = CBT outcomes similar no matter who provides the therapy
20
Q

What are the concerns about ADM and psychotherapy?

A
  • concerns about side effects (increased suicide risk) for ADM
  • may be side effects with psychotherapy, but less known
21
Q

What Biases have falsely inflated the efficacy of ADMs?

A
  • publication bias
  • outcome reporting bias
  • citation bias
22
Q

What are some reasons people with depression are more likely to be given ADMs than psychotherapy?

A
  • high demand
  • lack of access to psychiatrists/therapists
  • ADMs easily prescribed/highrate, at low cost
23
Q

What does a drug have to do to be FDA approved?

A

out perform a placebo

24
Q

What are the benefits and cons of having diagnostics….

A

pros - certainty or relief for some

cons - may not reflect individual experience of person experiencing, may limit understanding of mental illness

  • understanding mental illness beyond medical can expand understanding of diversity of lived experience and individual meaning
25
Q

How does mass media impact experience and meaning of mental illness

A
  • shapes understanding
  • many highly stigmatizing and negative
  • some shown not intentional by journalists
  • many producers willing to work with professionals to portray mental health more positively
26
Q

What is Critical appraisal and its importance?

A
  • who is the author and their affiliations
  • news source? fake or reputable?
  • is there high quality evidence to support this claim
  • important to source and appraise high quality evidence
27
Q

How does social media impact experience and meaning of mood disorders?

A
  • more participation for a voice/platform
  • share experiences and connect with others experiences and empower
  • fight stigma and raise awareness of real struggles
  • time spent on social media can make negative mental health symptoms…
  • quality of media use, not just frequency linked to rates of depression?
28
Q

How does arts and popular culture impact experience and meaning of mood disorders?

A
  • convey complexity of experiences
  • describe and move beyond medical diagnostic categories
  • evaluate assumption and limits of scientific knowledge
  • share experiences