Depression

Question 1

What is persistent depressed disorder?

Answer 1

Less severe but long lasting symptoms than MDD. Less common but has earlier. Long casting nature can lead to MDD (70%. ) tends to become a personality trait. Also has an earlier onset (11-12 years of age)

Question 2

What is disruptive mood regulation disorder?

Answer 2

This diagnosis was a response to over-diagnosis of BP among youth

① severe temper outbursts that are overreactions to situations
②chronica persistent irritable angry moved b/w those outbursts
③ overlap with ODD but odd kids have better emotional regulation.
4. low reliability due to lack f knowledge on how it may present
5. comorbidities
5. difficulty establishing DMDD as a discrete diagnosis

Question 3

Define bipolar disorder.

Answer 3

Depression & manic episodes.

Question 4

Define mood disorder

Answer 4

Mood disorders can be defined as poorly defined, persistent, extreme, ongoing poorly regulated emotions. Moods can vary from extreme unhappiness to hugh elation.
Types: BP AND MDD

Question 5

Which age group experienced the highest rate of MDD from 2008 toi 2012?

Answer 5

12-17 and 18-25 while those above 26 had fairly stable rates

Question 6

What is MDD?

Answer 6

It consists of the following characteristics for 2 weeks or more:
- irritable mood/depressed mood
- loss of interest/pleasure in activities
- distress and impairment in functioning
- other symptoms include but not limited to sleep disturbances, diff in concentrating and feeling worthless
-

Question 7

How can we categorise the symptoms of depression?

Answer 7

MOOD:
1. dysphoria - general dissatisfaction or general uneasiness with life
2. anhedonia - loss ofpleasure or interest in activities
3. irritable mood - annoyance, temper outbursts, touchiness

PHYSICAL/SOMATIC:
1. Insomnia-hypersomnia
2. wright loss/weight gain
3. fatigue - loss of energy
4. feeling restless or slowed dowm

COGNITIVE
1. lack of concentration or ability to think
2. ideas of worthlessness and excessive guilt which an turn into delusions
3. indecisiveness
4. low-self esteem: if it is hinging to one particular aspect and if it takes a hit then its harmful

SOCIAL
1. Withdrawal
2. Co-rumination - dep ppl attract dep ppl and tend to openly talk about negative feelings. Such individuals tend to bond over shared negative feelings. This can exacerbate feelings

Question 8

What are the 2 main characterizations that need to be present for an inovidual (atleast1) to be diagnosed?

Answer 8

1. Loss/diminished of interest.
2. Depressed/irritable mood most of the day, every day in almost all activities

Question 9

what are specifiers for MDD?

Answer 9

They help in diagnosis or assessment of MDD
1. Severity ratings of mild/moderate/devere are determined with the help of the following:
- number of symotoms
- amount of symptom distress
- impairment in eceryday functioning caused by the symptoms

2. In full or partial remission i.e if the person met criteria for MDD earlier and does not right now then are they depressed?
3. sINGLE OR RECURRENT EPISODE - chronicity is determined in regards to whn did the 1st ep was experienced
4. psychotic symptoms?? -delusion/hallucination
5. anxious symptoms: feeling tense, restless

Question 10

What kind of behaviours or symptoms should be expected in pre- pubescent ages

Answer 10

1. Somber/tearful
2. irritable
3. withdrawal from social activities
4. somatic complaints
5. poor school peformance
6. defiance/aggression

Question 11

PDD was also known as ___

Answer 11

Dysthymia

Question 12

What is double depressiom

Answer 12

presence of symptoms of both MDD and P-DD in a child

Question 13

What are some of rsk factors of MDD?

Answer 13

1. emotional reactivity - prevalent in preschoolers who are at higher risk of dperesssion. occurs even before an episode
2. gender orientation: girls and non-binary are at a higher risk. Girls because of differences in limbic system activation when processing sadness, use more ruminative coping style.
3. BIPOC youth face higher rates of depression but lower levels of treatment

Question 14

What is the role of race and ethnicity in the in determining depression rates?

Answer 14

• higher rates of depression among women
• racial discrimination was the best predictor of depression explaining 25% variance
• less availability and uptake of discriminated groups despite higher prevalence
• 16% first nations youth experienced depression as compared to 8% canadian populations

Question 15

What treatment has been successful in treating depression among youth?

Answer 15

1. CBT
2. Interpersonal psychotherapy for adoloscent depression - improving interpersonal functioning by enhancing communication skills in significant relationships has also helped

Question 16

How many of those diagnosed receive help for depression? discuss medicated and non-medicated treatments

Answer 16

50% only
- very few recieve non-med treatments like environmental intervention and therapy
- mostly meds

Question 17

Does depression lead to increased suicidality ?

Answer 17

Yes, however it is not the only determining factor of suicidal ideation. It increased chances of 1st suicide attempt among adolescents by 5 folds
- risk of suicide is accompanied by feelings of hopelessness, despair, helplessness about the future and how it will not improve
- depression exposes youth to most risk of committing suicide and double up during this stage however decline after 17-18 which can be attributed to brain maturation aiding in dealing beter with negative thoughts

Question 18

Discuss the Columbia- suicide severity rating scale

Answer 18

Suicidal ideation categories or levels:

1. Wish to be dead - lowest risk as peron has no plan or intent or method just an intent to be dead
2. Non-specific active (somewhat) suicidal thoughts: no plan or intent but just thoughts about killing self
3. Active suicidal ideation with any mehtods but no plans or intent to act : subject has thought of atleast 1 method durin assessment
4. Acive suicidal idealtion without any specific plan but some intent to act
   - still lacks a specific plans
5. Active suicidal ideation with specific plan and intent: thoughts on killing self with a method, intent and plan
   *** cOUNSELLING PERSPECTIVE: non-specific need to inform or violate privacy unless plans are specific and dangerous

Question 19

What is mania?

Answer 19

highly expansive and elated moods, inreased goal directed activity, feelings of euphoria(exaggerated sense of well being)

Question 20

What do manic episodes consist of ??

Answer 20

• exaggerated sense of well-beig and elation
• increased goal-directed activity that might not make sense to normal people
• unusually elevated, expansive or irritable mood
• mood can shift quickly to anger especialy towards the people obstructing their plans or goals
• grandiose delusions
• psychotic features

Question 21

What does the Youth Bipolar disorder present itself??

Answer 21

It has the follwoing charactersitics:

1. irritability/rage
2. overtalkative, sensitive, giddy
3. grandiose delusions and beliefs
4. sexual disinhibition
5. unrealistic elevation in self esteem
6. goal directed behavors: engaging in the same activity for multiple hpurs but on the contrary get distracted and restless very easily

Question 22

What is the controversy about the youth bipolar disorder?

Answer 22

• it occurs infrequently which contrasts with the major leap and overdiagnosis over the past decades
• overlaps symptoms with certain childhood disorders like ADHD
• lack of inter-rater reliabilty due to a lot of variability or differences among episodes
• mood swing, irritaility, aggression are common among children in general his can lead to over or misdiagnosis
• lack of diagnostic reliabilty

Question 23

What are the different kinds of depression?

Answer 23

bipolar 1: at least one episode of mania throughout lifetime
bipolar 2: atleast one ep of hypomania in combination to one or more MDD
3. cyclothymic disorder: persistent hypomania and depressive symptoms or low grade depression. Less severe and neither meet full criteria
4. Mixed features: wherein either mania or MDD dominates and the other is commonly subthreshold symptoms.