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Psych 354 > Chapter 5 - mood disorders > Flashcards

Chapter 5 - mood disorders Flashcards

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1
Q

What are the types of unipolar & bipolar disorders?

A

Unipolar:
- MDD
- persistent depressive disorder (dysthymia)

Bipolar:
- Bipolar I
- Bipolar II
- Cyclothymic

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2
Q

“Rules” for symptoms for an MDE?

A
  • 5 total symptoms → at least one “cardinal” one
  • must be persistent for at least 2 weeks
  • change from the persons own baseline
  • cause distress / impairment
  • NO MANIA
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3
Q

Cardinal symptoms for MDE? (must have how many?)

A

Need at least 1 of 2

  1. Depressed mood
  2. Anhedonia → loss of interest or pleasure in things you used to enjoy
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4
Q

Additional symptoms for MDE?

A
  • Sleep disturbance (hyper or hypo)
  • Weight (5%) or appetite change
  • Psychomotor agitation OR retardation
  • Fatigue
  • Worthlessness OR excessive guilt
  • Poor concentration OR indecisiveness
  • Thoughts of death, suicidal ideation, plan or attempt
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5
Q

Persistent depressive episode (dysthymia) symptoms?

A

Extremely similar to MDE
NO:
- suicidal thoughts
- excessive guilt/worthlessness
- psychomotor retardation OR agitation
- anhedonia

Includes:
- hopelessness
- low self esteem

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6
Q

Dysthymia def?

A
  • very chronic
  • “low dose” depression
  • At least 2 years
  • up to 25
  • can be periods of not depressed mood, but it can’t be more than 2 months
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7
Q

Manic episode 2 main types? How many additional symptoms needed?

A
  1. euphoric –> 3+ symptoms
  2. irritable –> 4+ symptoms
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8
Q

Manic episode symptoms:

A
  • elevated mood (euph./ irritable)
  • grandiosity
  • Decreased need for sleep
  • More talkative
  • racing thoughts
  • Distractibility
  • Increase in goal-directed activity
  • increased involvement in high-risk, high-reward behaviors
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9
Q

Manic episode criteria:

A
  • cause impairment, require hospitalization, or have psychotic features
  • needs to last for a week or more unless hospitalized
  • not due to substance/medical condition
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10
Q

Hypomanic episode criteria: (diff. from manic episode?)

A

Same as manic episodes BUT…
- duration shorter
- symptoms less severe

  • Must be noticeable to others but does NOT cause impairment
  • No psychotic symptoms
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11
Q

What kind of episodes / how many / how long characterize each mood disorder?
(BP1&2, MDD, PDD)

A

Bipolar I → at least one manic, depression not actually required
Bipolar II → at least one hypomanic episode, at least one MDE
———-
MDD → at least 1 MDE (2 weeks)
PDD → depressive symptoms for at least 2 years

^^NO manic episodes

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12
Q

Cyclothymic disorder?

A
  • Frequent periods of depression and hypomania over years
  • Low grade manic symptoms and depressive symptoms
  • No history of:
    → MD episode
    → Manic episode

Symptoms NOT episode

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13
Q

2 kinds of specifiers to mood disorders? What kind can they be applied to?

A
  1. psychotic features (uni & bipolar)
  2. rapid cycling (bipolar only)
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14
Q

Psychotic features specifier? 2 types? More likely to…?

A
  • during the mood episode
  • Mood-congruent → consistent with theme of disorder
  • Can also be incongruent

More likely to need:
- hospitalization
- psychotropic medication

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15
Q

Rapid cycling specifier def? Who is more likely to have it?

A
  • At least 4 episodes of MDE, manic, or hypomania within 12 month time

More likely if:
- woman
- history of more episodes
- earlier onset
- associated with history of suicide attempts

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16
Q

Gender breakdown for mood disorders?

A
  • Women more likely for mood disorder overall
  • Manic episodes are about equal between genders
  • Boys more likely before puberty
  • no age gap 65+
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17
Q

Depression occurs (more/less) frequently in elderly?

A

Less!

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18
Q

Depression etiology:
Environmental factors?

A

stressful life events
interpersonal factors

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19
Q

Depression etiology:
Biological factors?

A

HPA axis
genetic vulnerability
brain function
neurochemical

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20
Q

Depression etiology:
Psychological factors?

A

Info process bias
cognitive distortions
rumination
Personality

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21
Q

Bipolar etiology:
Environmental factors?

A

stressful life events
goal attainment events
interpersonal factors
schedule disruption

22
Q

Bipolar etiology:
Biological factors?

A

genetic vulnerability
brain function??

23
Q

Bipolar etiology:
Psychological factors?

A

cognitive distortions
grandiose thinking

24
Q

James Coyne:
- big philosophy on why people are depressed?
- what were his 2 hypotheses on interpersonal relations & depression?

A
  • Depressed people affected by negative cognitive distortions
  1. People respond differently to depressed people because they are depressed, not because they have a mental disorder in general
  2. Depressed people induce depressed mood and hostility in others and are rejected socially
    → rejected because people don’t want to feel negative emotions they get from interacting with depressed people
25
Q

People separated or divorced are _____ to be depressed among people of diff. marital status?

A

MOST likely

26
Q

Never married vs. married people:
who has higher rates of depression?

A

never married people!

27
Q

Stressful life events that include ____ (3 feelings) are MOST LIKELY to contribute to mood disorders

A
  • humiliation
  • entrapment
  • defeat
28
Q

Greater social support is associated with…?

A
  • Reduced likelihood of relapse
  • recovering more quickly
29
Q

Social rhythm stability hypothesis?

A
  • Sensitive to events that disrupt their daily rhythms or daily life
  • Circadian vulnerability
  • events that interrupt sleep schedule can increase symptoms / trigger episode
30
Q

Cognitive distortions common in depression:
3 types? ex?

A

Internal:
- “my fault”
- failed exam bc I didn’t study enough

Global:
- affects everything in my life
- “I’m going to fail my other tests, other classes, etc”

Stable:
- “always going to happen”
- I AM a failure, I’m always going to be a failure
- reflects something characteristic of the person

31
Q

Only about ___% of people who meet criteria for a mood disorder seek help within 6 months of diagnosis?

A

30%

32
Q

5 major types of medications for unipolar depression?

A
  1. Monoamine oxidase inhibitors (MAOIs)
  2. Tricyclics (TCAs)
  3. Selective serotonin reuptake inhibitors (SSRIs)
  4. SSNRIs
  5. Atypical
33
Q

about ___% of people who don’t respond to the first medication respond to the second?

A

50%

34
Q

MAOIs: important things?

A
  • first medication! (1950s)
  • were effective!
  • lots of dangerous side effects
  • could be fatal with certain foods
35
Q

Tricyclics: important things?

A
  • 1950s/60s
  • also a lot of unpleasant side effects
  • but non-fatal
  • dry mouth/sex issues, etc
36
Q

SSRIS / SNRIS: important things?

A
  • Developed in 1980s
  • As effective as tricyclics, but fewer side effects
  • Block serotonin at synapse
  • Lower sexual interest, insomnia, gastrointestinal issues

SNRIs also affect norepinephrine

37
Q

Atypical: important things?

A
  • ex. welbutrin
  • effective for depression with lethargic symptoms, like weight gain & fatigue
38
Q

Other biological treatments? Used when?

A
  1. ECT
  2. Deep Brain Stimulation
  • used only for people resistant to other forms of treatment
39
Q

Electroconvulsive Therapy (ECT)?

A
  • Electric current administered to induce small seizure

side effects:
- confusion
- memory loss

40
Q

Deep brain stimulation? Effectiveness?

A
  • Implanted neurostimulator
  • High frq electric currents to specific regions of the brain
  • Triggers blood flow
  • Data is inconsistent ab its effectiveness for treating depression
41
Q

Interpersonal Therapy focuses on…? What 4 areas might they talk about?

A
  • current relationships that contribute to depression (usually familial)
  • Building communication and problem-solving skill
  1. Grief
  2. role dispute
  3. role transition
  4. interpersonal deficits
42
Q

Behavioral activation therapy? Goals? 2 types of activities? Effectiveness?

A
  • Based on how depressed people often disengage from routines
  • Focuses on increasing activities

Goals:
- get patients to do activities they might / used to enjoy
- positive reinforcement
- reduce withdrawal / avoidance behaviors

  1. Pleasant activities
  2. Mastery activities (sense of achievement)
  • as effective or more than CBT
43
Q

2 types of meds for bipolar patients? importance?

A
  • meds is the first line of treatment
  • Lithium
  • Anticonvulsants
44
Q

Lithium: uses? pros & cons/limitations? works for __%?

A
  • recover from & prevent future episodes
  • effective for treatment of manic & depressive episodes
  • less likely to experience relapse if you continue taking it between episodes
  • works for about 60% of patients
  • 40% don’t improve
  • especially among rapid-cycling & comorbid alcohol abuse
  • negative side effects
  • compliance
45
Q

Anticonvulsant drugs?

A
  • effective in about 50% of patients
  • usually used for patients who don’t respond to lithium

side effects:
- gastrointestinal distress
- sedation

46
Q

Family focused treatment for bipolar?

A
  • designed for people with recent episode
  • ~ 1 year
  • 3 stages
    1. psychoeducation & stabilization
    2. communications enhancement training
    3. problem solving skills
47
Q

Risk factors for suicide?

A
  • OLD WHITE MEN
  • Alc dependence
  • hospitalized
  • schizophrenia
  • low social support
  • separated or divorced
  • MOOD DISORDER
  • highly creative or successful professionals
48
Q

Who attempts vs commits suicide?

A

Attempts:
- 18-24 yr olds
- Women 3x more than men!

Deaths:
- Men&raquo_space; women
- White&raquo_space; black
- Older&raquo_space; younger

49
Q

__% of people who die by suicide never saw a mental health professional?

A

50%

50
Q
A

Psych 354 (10 decks)

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