Depressive Disorder Flashcards
What are types of depressive disorder?
Disruptive mood dysregulation disorder
Major depressive disorder
– Single episodes
– Recurrent episodes
Persistent depressive disorder (Dysthymia)
Premenstrual dysphoric disorder
What is a depressive disorder?
As a group, these are characterized by “sad, empty, or irritable mood.”
Symptoms in this cluster of disorders include somatic and cognitive changes which typically affect an individual’s ability to function.
Depressed mood is characteristic of all these disorders.
Distinctions: severity, duration of episodes, degree of chronicity, and presumed etiology
Usually diagnosed in children.
What is major depressive disorder?
Major depressive episodes characterize both the bipolar and depressive disorders.
For a diagnosis of, the individual must show 5 symptoms that include depressed mood or anhedonia and four other manifestations of depression. May include:
- Weight loss.
- Insomnia or hypersomnia almost every day.
- Fatigue or lack of energy.
- Feelings of guilt or worthlessness.
- Difficulty concentrating.
- Repeated suicidal ideation.
The symptoms must cause distress and dysfunction. They must be distinguished from grief following a loss and must occur almost daily for 2 weeks.
What is the etiology of major depressive disorder?
Precise characteristics of the genetic factors are not yet established.
Twin heritability rate at 37%.
More frequently diagnosed in women than in men.
What is the prognosis for major depressive disorder?
Outcomes will vary; some do well, experience few recurrences and better post episode function and others have chronic and severe courses. More positive emotion is associated with better outcome.
Prognostic factors for recurrence:
- Severity of the episode and severe symptoms of depressed mood, intense sadness, and anorexia.
- Long working hours
- Work-family conflict
- Negative thinking
- Co-existing social phobia.
What are some implications for major depressive disorder?
Function in all occupations likely to be affected.
The degree of occupational deficit is associated with the demands of the individual’s circumstances.
Major skill deficits during a major depressive episode are cognitive, particularly executive function and memory. Memory deficits tend to persist, even when individual episodes of depression remit.
Emotional regulation is significantly impacted.
Focuses greater attention on negative than positive emotion and remember negative emotion more consistently.
Significant issue: sexual function.
- Sexual interest is typically decreased during depressive episode.
- Most medications used for treatment have significant sexual side effects.
- This occupation will likely be impacted by the disorder and the treatment.
What are some treatments for major depressive disorder?
Psychotherapeutic approaches and psychopharmacology have been well established in treating these disorders.
CBT can be useful in resolving individual episodes and reducing the risk of recurrence.
What is dysthymia (persistent depressive disorder)?
Is more chronic but typically less severe than major depressive disorder.
It is a combination of characteristics from the DSM-4 conditions: chronic major depressive disorder and dysthymic disorder.
Diagnostic criteria: appetite changes, poor sleep, fatigue, low self-esteem, difficulty concentrating, and feelings of hopelessness.
Duration: 2 years, with no more than two months symptom free
Etiology: unclear
Prognosis: relatively intractable
Implications: same as indicated for major depressive d/o
What is premenstrual dysphoric disorder?
Since DSM-4, it has been moved to this cluster.
5 or more symptoms before and during menses: emotional lability (emotions all over the place), irritability, depressed mood, anxiety, decreased interest in activities, poor concentration, lethargy, changes in appetite and sleep, feelings of being overwhelmed or out of control, and physical symptoms.
Condition must interfere with individual’s daily function.
Rule out: depression, cyclothymia, dysthymia, substance use, or medical conditions.
Etiology: unclear
Prognosis: resolves with onset of menopause
Implications: cognitive and functional impairments; primarily emotional regulation impaired; working memory has been demonstrated to be impaired. May have higher absenteeism and lower productivity at work.
What is seasonal affective disorder?
Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons — SAD begins and ends at about the same times every year.
Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications.
What is disruptive mood dysregulation?
Refers to presence of symptoms (persistent irritability and frequent episodes of extreme behavioral dysfunction/dyscontrol) for children up to 12 years of age
What are anxiety disorders?
The most common of all psychiatric disorders
Affect approximately 40 million adults (18%) in the U.S. aged 18+ each year.
Anxiety: unpleasant emotional, cognitive, behavioral, or physical experiences of stress
There are certain medical conditions that may produce acute experiences of anxiety such as hyperthyroidism, estrogen loss, congestive heart failure, asthma, and such.
Normal anxiety: worry that propels one to act.
Clinical anxiety: worry that disrupts function.
What are symptoms of anxiety?
Emotional: feeling uneasy, overwhelmed, helpless and out of control.
Physiological: cardiovascular, GI, respiratory, urinary, genital, autonomic, muscular
Cognitive: confusion, poor memory, loss of perspective, obsessive thoughts, poor problem solving.
Behavioral: looks preoccupied, immobile, overactive, restless, excess, or decreased consumption of substances/foods, rituals to alleviate anxiety.
What is a panic attack?
4 or more symptoms in 10 minutes
- cardiac symptoms
- trembling
- shortness of breath
- feeling of suffocation
- chest pain
- sensations of choking
- nausea
- dizziness
- derealization
- paresthesia
- chills
- hot flashes
- fear of losing control
What is selective mutism?
Selective Mutism is a complex childhood anxiety disorder characterized by a child’s inability to speak and communicate effectively in select social settings.
The majority of these children have a genetic predisposition to anxiety.
