depression Flashcards
What is the prominent model?
serotonin hypothesis
what is the psychological intervention
CBT
what is the biological intervention
antidepressants SSRI’s
Background of serotonin hypothesis
in 1950’s found blood pressure medication reduced serotonin and low mood
Who made the serotonin hypothesis model
Kessler & nemeroff 2000
what is the serotonin hypothesis model
hypoactivity in serotonin system, complex pattern of atypical activity in the norepinephrine system mostly hyperactivity some hyperactivity
what kind of activity in the serotonin system
hypoactivity
what kind of activity in the norepinephrine system
mostly hyperactivity some hypoactivty
where has hypoactivty
serotonin system
where has mostly hyperactivity
norepinephrine system
what studies support the serotonin hypothesis
acute tryptophan depletion studies
what happens in a acute tryptophan depletion studies
PP’s drink a drink with tryptophan and measure mood
what does the drink with tryptophan do
prevents tryptophan travelling through the blood brain barrier which reduces serotonin in the brain
what does tryptophan do
helps make serotonin
what did Ruhe et al 2007 do?
a ATD meta analysis of 45 studies in a range of people
what did Ruhe et al 2007 find
ATD caused depressive mood in those with/ who used to have depression but not those without
name a ATD study
Ruhe et al 2007 meta anayslsis
what did harmer et al 2017 find?
a delayed effect in SSRI’s
what did harmer et al 2017 findings show
atypical serotonin contributes to depression but is not causal
who authorised use of SSRIs
NICE 2004 using meta analysis’
what did turner et al 2008 do
looked at published results of SSRI studies
what did turner et al 2008 find
37/38 positives studies were published but only 14/36 of negative findings were and 11 of those misrepresented the results but effect size did not change when compared
what did hieronymous et al 2016 do
looked at how SSRI’s effected different symptoms
what did hieronymous et al 2016 find
SSRI’s effected different symptoms differently and SSRIs improve low mood but not all symptoms such as agitation
should we group depressive symptoms and why?
no why? SSRI’s effected different symptoms differently
what does CBT for MDD aim to do
identify negative thoughts, challenge them as irrational and replace with rational thoughts
what are CBT methods
diary to record negative beliefs to identify triggers, give coping strategies, behavioural activation
name the old study for CBT
Glaoguen et al 1998
what did Glaoguen et al 1998 do
meta analysis of 20 studies for CBT vs placebo in MDD
what did Glaoguen et al 1998 find
CBT was more effective
what did Cuijpers et al 2014 do?
looked at RCT’s for CBT
what did Cuijpers et al 2014 find?
only 11 RCTs were high quality but found significant effect of CBT but lower effect size in higher quality compared to lower quality RCT
what did Cuijpers et al 2008 do?
looked at CBt with 7 other interventions
what did Cuijpers et al 2008 find?
CBT to be most effective alongside psychodynamic therapy
does the research support the serotonin hypothesis
yes but it also shows atypical serotonin contributes to depression but is not causal there could be more that contributes
study 2 for SH
caspi 2003
what did caspi do
looked at genetic variation in the serotonin transporter gene and seen if depression was more likely
what did caspi find
genetic variation + stress = more chance of depression
