depression I Flashcards
Order of depression disorders in DSM:
Disruptive Mood Dysregulation – Major Depressive Disorder – persistent depressive disorder – premenstrual dysphoric disorder
What do all depression disorders in dsm have in common, what differs?
common: presence of sad, empty, irritable mood that affects individuals capacity to function.
difference: duration, timing, severity, presumed etiology
What are the symptoms of disruptive mood dysregulation disorder?
chronic, severe, persistent irritability temper outburst. occurs in kids 12 years or younger
what criteria need to be met for someone to be diagnosed with disruptive mood dysregulation disorder?
Severe recurrent temper outbursts, inconsistent with developmental level, occurs 3 or more times per week, been present for 12 or more months, present in at least two of three setting such as home, at school, or with peers.
Highly transdiagnostic system:
something being present in a lot of different mental disorders
Comorbity:
when an individual has two or more distinct illnesses at the same time
What are cardinal symptoms?
the primary/most important symptoms of a disorder
What are the cardinal symptoms of major depressive disorder?
- depressed mood most of the day, nearly everyday. (feeling sad, empty, hopeless)
- Loss of interest or pleasure in all, or almost all activities most of the day, nearly everyday
What are the two distinct symptoms having to do with reward sensitivity?
loss of interest and loss of pleasure
Anhedonia:
more severe symptom of loss of pleasure, when you really never enjoy things you usually would enjoy
Other than the cardinal symptoms, what are the other symptoms of MDD?
- weight loss, weight gain, or decrease in appetite nearly everyday.
- Insomnia or hypersomnia nearly everyday
- Psychomotor agitation (state of restlessness) or retardation nearly everyday.
- fatigue or loss of energy nearly everyday
- feelings of worthlessness/guilt nearly everyday
- diminished ability to think or concentrate, or indecisiveness nearly everyday
- recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt or plan for committing suicide
Criteria symptoms for diagnosing MDD:
- must be present for most of the day nearly everyday.
- must be present for at least 2 consecutive weeks
- episode must be accompanied by clinically significant distress of impairment in social, occupational, or other important areas of functioning
- 5 or more of the symptoms must be present, with at least one of the symptoms being one of the cardinal symptoms
Bereavement:
period of grief/mourning after a death
What is the idea of bereavement?
to distinguish between depression and normal sadness/grief
Normal grief phases:
- numbing/disbelief
- yearning/searching for dead person
- disorganization/ despair to permanent loss
- reorganization to rebuild
characteristics of grief:
have capacity for positive emotional experiences, dysphoria (general dissatisfaction with life) occurs in waves, fleeting thoughts of being with the person who died
Persistent Depressive disorder is ____ compared to MDD
Less severe and more chronic
Criteria for diagnosing Persistent Depressive disorder:
depressed mood for most of the day, for more days than not, for at least 2 years, with two or more of the symptoms besides feeling depressed. symptoms also must cause clinically significant distress or impairment in important areas of functioning
Symptoms of Persistent depressive disorder
- poor appetite or overeating
- insomnia or hypersomnia
- low energy
- low self esteem
- poor concentration or indecisiveness
- feelings of hopelessness
Dysthymia:
chronic major depression, and double depression
Double depression:
mild, but chronic form of depression. combination of persistent and major depressive disorder
How much does PDD impact social and occupational functioning as compared to MDD?
effects can be as great or greater
Specifiers:
diagnostic extension that accounts for variation in disorder. important for determining outcomes, direction of treatment, grouping of symptoms
What are the specifiers?
- with melancholic features
- with atypical features
- with catatonic features
- with seasonal pattern
- with permpartum onset
- with anxious distress
- with psychotic features
- with mixed features
Characteristic symptoms of someone with melancholic features specifier:
loss of pleasure in all activities, depression worse in morning, excessive guilt
Characteristic symptoms of someone with atypical features specifier:
mood reactivity- brightens to positive events. two of the four symptoms: weight gain, hypersomnia, arms and legs feel heavy, being sensitive to interpersonal rejection
Characteristic symptoms of someone with catatonic features specifier:
range of psychomotor symptoms from motor immobility to extensive psychomotor activity. such as someone staring blankly and won’t respond then you speak to them, or sitting in an unusual position and won’t move.
Characteristic symptoms of someone with seasonal pattern specifier:
at least two or more episodes in past 2 years that have occurred at the same time (usually fall or winter seasons) and full remission at the same time
Characteristic symptoms of someone with peripartum onset specifier:
mood symptoms occurred during pregnancy, or in the 4 weeks following delivery
Characteristic symptoms of someone with anxious distress specifier:
feeling distressed, anxious, fear of losing control or that something bad might happen
Characteristic symptoms of someone with psychotic features specifier:
delusions of hallucinations present, feelings of guilt and worthlessness. Mood congruent (delusions/ hallucinations in line with depressive themes) or mood incongruent
Characteristic symptoms of someone with mixed features specifier:
increased energy, elevated/ expansive mood, talkative. mania like but doesn’t meet criteria for bipolar
Remission:
lessening of the severity of the disease
Specify remission if:
in partial remission: symptoms of previous episode are present, but full criteria are not met, or period lasting less than 2 months without any significant symptoms of major depressive episode
in full remission: during the past 2 months or more, no significant signs of symptoms
Mild severity and how many symptoms have to be present?:
few, if any symptoms present. symptom intensity distressing but manageable. 5-6 symptoms must be present
Moderate severity and how many symptoms have to be present?:
the number and intensity of symptoms or functional impairment are between those specified for mild and severe. 7-8 symptoms required
Severe severity:
number of symptoms in excess of that required to make diagnosis, symptom intensity is seriously distressing and unmanageable. really interferes with social and occupational functioning. all 9 symptoms must be present
Specify course:
single: having one major depressive episode
recurrent: having more than one major depressive episode. must be an interval of at least 2 consecutive months between current and previous episode
What do you have to specify for depressive disorders?
come up with specifier, specify remission, specify severity, specify course
are specifiers specific for certain categories?
yes, sometimes
Specifiy for PDD if:
early onset: before age 21
late onset: 21 or older
Premenstrual dysphoric disorder diagnostic criteria:
at least 5 symptoms must be present before period, improve after onset of period, become minimal or absent in the week after period
symptoms of PMDD:
- mood swings
- irritability or anger or increased interpersonal conflicts
- depressed mood, feelings of hopelessness, self deprecating thoughts,
- loss of interest in activities
- lack of energy
