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PSC 168 > Chapter 8: Mood Disorders > Flashcards

Chapter 8: Mood Disorders Flashcards

1
Q

Define depression.

A

A low, sad state in which life seems dark and its challenges overwhelming

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2
Q

Define mania.

A
  • Opposite of depression
  • State of breathless euphoria and frenzied energy in which people may have an exaggerated belief that the world is theirs for the taking
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3
Q

How is depression a “spectrum disorder”?

A

Spectrum from feeling blue all the way to psychotic or suicidal depression

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4
Q

What is unipolar depression?

A
  • Depression w/o a history of mania

- Return to nearly normal mood when depression lifts

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5
Q

What are the different categories of symptoms of depression? Examples?

A
  • Emotional = sadness, crying, anhedonia, anger, anxiety
  • Cognitive = poor memory & concentration, inability to make decisions, pessimism
  • Physical = general pain, headaches, low energy, decreased appetite, sleep, sex drive
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6
Q

What is the DSM-V definition of a major depressive episode?

A

For at least 2 weeks, at least 5 of the following symptoms must be met. (at least one of the first 2 must be present)

  • Depressed mood most of the day
  • Anhedonia = diminished interest or pleasure in almost all activities previously enjoyed
  • Significant weight loss or weight gain or significant change in appetite
  • Insomnia or hypersomnia
  • Psychomotor retardation or psychomotor agitation nearly everyday
  • Indecisiveness or diminished ability to concentrate
  • Fatigue or loss of energy nearly everyday
  • Feelings of worthlessness or inappropriate guilt
  • Recurrent thoughts of death and/or suicidal ideation
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7
Q

What is the DSM-V definition of major depressive disorder?

A
  • Entails a history of one or more major depressive episodes

- Symptoms severe enough o cause clinically significant distress or impairment

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8
Q

List the specifiers or MDD?

A
  • Single episode vs. recurrent episodes
  • Mild, moderate, severe MD episodes
  • With psychotic features
  • With mixed features
  • With anxious distress
  • With seasonal pattern
  • With peripartum onset
  • With atypical features
  • With catatonic features
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9
Q

What are the factors that contribute to a single episode vs. recurrent episodes of MDD?

A
  • 75% of those who have one episode will have at least one other
  • If only one episode, it was likely in response to a major life stressor
  • W/o treatment, an MDD sufferer has on avg 5-6 episodes in a lifetime
  • An untreated MD episode lasts 8-10 months
  • Recovery after an episode may be complete or mild depression left
  • Dangers of repeated untreated episodes for long-term brain dysregulation
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10
Q

Describe the psychotic features of MDD.

A
  • Psychotic symptoms = breaks w/ reality, delusions, hallucinations
  • Always associated w/ a severe episode, but severe episodes don’t have to include psychosis
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11
Q

Describe the mixed features of MDD.

A
  • Presence of manic symptoms pointing at possibility of underlying bipolar disorder
  • Feeling mostly depressed but combined w/ increased energy level, irritability, restlessness, impulsiveness, high risk of suicide
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12
Q

Describe the anxious distress specifier of MDD.

A

Anxiety symptoms beyond what would be expected for depressive state

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13
Q

Describe the seasonal pattern of MDD.

A
  • Seasonal Affective Disorder (SAD)

- Low energy, oversleeping, craving carbs

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14
Q

Describe the peripartum onset of MDD.

A

Onset of symptoms during or after pregnancy

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15
Q

Describe the atypical features of MDD.

A
  • Significant weight gain and increase in appetite
  • Hypersomnia
  • Long-standing pattern of interpersonal rejection sensitivity
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16
Q

Describe the catatonic features of MDD.

A
  • Motoric immobility or stupor
  • Not responding to instructions
  • Odd, bizarre postures
  • Echoalia or echopraxia (repeating others speech or movements)
  • Motionless alternates w/ agitation
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17
Q

Endogenous vs. Exogenic depression

A
  • Endogenous = response to internal factors

- Exogenic = aka reactive; follows clear-cut stressful events

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18
Q

What is the DSM-V definition of persistent depressive disorder?

A
  • Chronic pattern of depression that has lasted for at least 2 years
  • Person experiences depressive symptoms that are mild, moderate, or severe
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19
Q

What is premenstrual dysphoric disorder?

A

Marked change in mood during a woman’s premenstrual period

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20
Q

What is the one year prevalence of MDD?

A

8%

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21
Q

What is the gender ratio for MDD?

A

2:1 (female: male)

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22
Q

What is the typical age onset of MDD?

A

24-29 years old

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23
Q

What is the percentage of people currently receiving treatment for MDD?

A

50%

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24
Q

What is the one year prevalence of dysthymic disorder?

A

1.5-5%

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25
Q

What is the gender ratio of dysthymic disorder?

A

Between 3:2 and 2:1

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26
Q

What is the typical age onset of dysthymic disorder?

A

10-25 years old

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27
Q

What is the percentage of people currently receiving treatment for dysthymic disorder?

A

36.8%

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28
Q

What are the different theories as to why women are more prone to depression?

A
  • Artifact theory
  • Hormone explanation
  • Life stress theory
  • Body dissatisfaction explanation
  • Lack of control theory
  • Rumination theory
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29
Q

Explain the artifact theory of gender and depression.

A
  • Women and men equally prone to depression, but clinicians often fail to detect depression in men
  • Women display more emotional symptoms
  • Men find it less socially acceptable to admit feeling depressed or to seek treatment
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30
Q

Explain the hormone theory of gender and depression.

A
  • Hormone changes trigger depression in women

- Gender differences in rates of depression span the same years of hormone level changes in women

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31
Q

Explain the life stress theory of gender and depression.

A
  • Women in our society experience more stress than men

- More poverty, menial jobs, less adequate housing, more discrimination

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32
Q

Explain the body dissatisfaction explanation of gender and depression.

A
  • Females in western society are taught to seek a low body weight and slender body shape
  • Cultural standards for males much more lenient
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33
Q

Explain the lack of control theory of gender and depression.

A
  • Women feel less control than men over their lives
  • Women more prone to develop learned helplessness in lab
  • Victimization of any kind can produce a general sense of helplessness and increases symptoms of depression
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34
Q

Explain the rumination theory of gender and depression.

A

Women more likely than men to ruminate when their moods darken, making them more vulnerable to the onset of depression

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35
Q

What biochemical factors influence the cause of depression?

A
  • Low activity of norepinephrine and serotonin linked to unipolar depression
  • Depressed peeps have an overall imbalance in the activity of serotonin, norepinephrine, dopamine, and acetylcholine
  • Deficiencies w/in neurons may impair the health of neurons and lead to depression
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36
Q

What is the brain circuit associated w/ depression? What is the role of each in depression?

A
  • Prefrontal cortex = lower activity and blood flow in depressed peeps
  • Hippocampus = hippocampal neurogenesis decreases dramatically when peeps are depressed
  • Amygdala = blood flow and activity is greater in depressed peeps –> express more negative emotions and memories
  • Brodmann Area 25 = “depression switch” more active in depressed peeps
37
Q

How does the immune system play a role in depression?

A
  • Depressed peeps display lower lymphocyte activity, increased CRP production and body inflammation
  • Depressed peeps have higher incidence of migraines, irritable bowel syndrome, chronic fatigue syndrome, rheumatoid arthritis
38
Q

Explain the psychodynamic view of depression.

A
  • Similarity between clinical depression and grief in peeps who lost a loved one –> crying, loss of appetite, difficulty sleeping, anhedonia, withdrawal
  • 2 kinds of peeps likely to become depressed:
  • Those whose parents failed to nurture them and meet their needs during oral stage become overly dependent and have low self esteem
  • Those whose parents overly gratified needs resist moving on to subsequent stages
  • Symbolic/imagined loss = equate other events as a loss of a loved one
39
Q

Explain the behavioral view of depression.

A
  • Unipolar depression results from significant changes in the # of rewards and punishment peeps receive in their lives
  • Decline in rewards leads them to perform fewer constructive behaviors
40
Q

What are the components of the theory of negative thinking and their roles in depression?

A
  • Maladaptive attitudes = inaccurate, set stage for negative thoughts and reactions
  • Cognitive triad = interpreting their experiences, themselves, and their futures in a negative way
  • Errors in thinking = negative conclusions based on little evidence, minimizing positive experiences, magnifying negative ones
  • Automatic thoughts = steady train of unpleasant thoughts that cause or maintain depression, anxiety, or other psychological dysfunction
41
Q

Explain learned helplessness and its role in depression.

A

Perception, based on past experiences, that one has no control over one’s reinforcements and that they themselves are responsible for this helpless state

42
Q

Explain the family-social perspective of depression.

A
  • Depression tied to unavailability of social support such as that found in a happy marriage
  • Peeps who are isolated w/o intimacy more prone to becoming depressed
  • Depressed peeps have weaker social skills and communicate poorly
43
Q

How does culture play a role in depression?

A
  • Depressed peeps in non-Western countries are more likely to be troubled by physical symptoms (fatigue, weakness, weight loss, sleep disturbances)
  • Less often marked by cognitive symptoms like self blame, low self esteem, guilt
44
Q

What is the DSM-V criteria for a manic episode?

A

-Abnormally high energy level
-Abnormally and persistently elevated, expansive, or irritable mood
-Symptoms last one week OR hospitalization needed
(at least 3 of the following)
-grandiosity or inflated self-esteem
-decreased need for sleep
-increased talkativeness
-racing thoughts
-distractibility
-Psychomotor agitation or increase in goal-directed activity
-Poor judgment (buying sprees, sexual indiscretions, foolish investments)

45
Q

What is the DSM-V criteria for a hypomanic episode?

A

Types of symptoms are the same for manic episode EXCEPT:

  • less severe
  • less impairment in social or occupational functioning
  • no psychotic symptoms
  • hospitalization not needed
  • symptoms need to last at least 4 days
46
Q

What is the criteria for bipolar I disorder?

A
  • At least one manic episode

- Usually mania alternates w/ major depression, but there doesn’t need to be depression to meet criteria

47
Q

What is the criteria for bipolar II disorder?

A

At least one hypomanic episode and one or more major depressive episodes

48
Q

What is the criteria for cycolothymia?

A
  • For at least 2 years, periods of hypomania symptoms and depressive symptoms
  • Depressive symptoms are milder than w/ bipolar II disorder
49
Q

What are the specifiers of bipolar I and II disorder?

A
  • With psychotic features
  • With mixed features
  • With anxious distress
  • With seasonal pattern
  • With peripartum onset
  • With rapid cycling
50
Q

What is rapid cycling?

A
  • More than 4 episodes w/in one year, but usually many more

- Can be precipitated by going off mood stabilizing meds or taking antidepressants only

51
Q

What percentage of bipolars are rapid cyclers? What percentage of them are women?

A
  • 20%

- 90%

52
Q

What is the one year prevalence of bipolar I disorder?

A

1.6%

53
Q

What is the gender ratio of bipolar I disorder?

A

1:1

54
Q

What is the typical age onset of bipolar I disorder?

A

15-44 years old

55
Q

What is the percentage of people currently receiving treatment for bipolar I disorder?

A

33.8%

56
Q

What is the one year prevalence of bipolar II disorder?

A

1%

57
Q

What is the gender ratio of bipolar II disorder?

A

1:1

58
Q

What is the typical age onset of bipolar II disorder?

A

15-44 years old

59
Q

What is the percentage of people currently receiving treatment for bipolar II disorder?

A

33.8%

60
Q

What is the one year prevalence of cycolothymia?

A

0.4%

61
Q

What is the gender ratio of cycolothymia?

A

1:1

62
Q

What is the typical age onset of cycolothymia?

A

15-25 years old

63
Q

What is the avg onset and trend of MDD?

A
  • Avg onset = mid to late 20s

- Trend = earlier and earlier

64
Q

What is the course of MDD?

A
  • With each episode, more episodes likely

- After 3 episodes, life-long MDD likely

65
Q

What is the lifetime prevalence of MDD?

A

10-15%

66
Q

What is the gender ratio of MDD?

A

2:1 (female: male)

67
Q

What is the onset of PDD?

A
  • Onset of chronic low level depression can be early (childhood, teens)
  • Onset may be slow, starting w/ milder symptoms
68
Q

What is the course of PDD?

A
  • Chronic by definition (at least 2 years of duration)

- May develop into severe MDD

69
Q

What is the lifetime prevalence of PDD?

A

6-7%

70
Q

What is the gender ratio of PDD?

A

2:1 (female: male)

71
Q

What is the onset of PMDD?

A

Puberty at the earliest

72
Q

What is the course of PMDD?

A

Likely to vary throughout life cycle

73
Q

What is the lifetime prevalence of PMDD?

A

3-8%

74
Q

What is the onset, avg onset and trend of bipolar I disorder?

A
  • Avg = 18 (50% started by adolescence)
  • Trend = earlier and earlier
  • Mania rarely starts after age 40 unless prior history of depression
  • More acute onset than MDD
75
Q

What course does bipolar I disorder take?

A
  • Worse w/ childhood onset
  • Risk of deterioration w/o treatment
  • Pattern may change throughout life
  • Chronic disorder, but manageable w/ meds
76
Q

What is the lifetime prevalence of bipolar I disorder?

A

1.5%

77
Q

What is the gender ratio of bipolar I disorder?

A

1:1

78
Q

When is the avg onset of bipolar II disorder?

A

22 years old

79
Q

What course does bipolar II disorder take?

A

May develop into bipolar I disorder

80
Q

What is the lifetime prevalence of bipolar II disorder?

A

1-2%

81
Q

What is the gender ratio of bipolar II disorder?

A

1:1

82
Q

What is the onset of cyclothymic disorder?

A
  • Teens

- Slow onset

83
Q

What course does cyclothymic disorder take?

A

50% later meet criteria for bipolar I or bipolar II disorder

84
Q

What is the lifetime prevalence of cyclothymic disorder?

A

1-2%

85
Q

What is the gender ratio of cyclothymic disorder?

A

1:1

86
Q

What role does genetics play in mood disorders?

A
  • No single gene responsible for any mood disorders

- Mood disorders are polygenic disorders

87
Q

What have twin studies shown about MDD?

A
  • Identical twin has MDD –> 46% chance other identical twin has MDD
  • Fraternal twin has MDD –> 20% change other fraternal twin has MDD
88
Q

What have twin studies shown about bipolar I disorder?

A

Identical twin has bipolar I disorder:

  • 40% chance that other identical twin is bipolar I
  • 80% chance that other identical twin is bipolar I or has MDD
89
Q

What do mood disorders have to do w/ creativity?

A
  • Mood disorders are over-represented among creative individuals (poets, writers, artists)
  • About 20% of famous poets found to be bipolar
  • Many committed suicide
  • High productivity and creativity in hypomanic state

PSC 168 (18 decks)

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