Depressive Disorders Flashcards
What are the 5 depressive illnesses?
What are the aspect differences?
- Major Depressive Disorder
- Persistent Depressive Disorder (aka Dysthimia)
- Premenstrual Dysphoric Disorder
- Substance/Medication-Induced Depressive Disorder
- Disruptive Mood Disregulation Disorder
*for children younger than 12
will differ by duration, timing, or presumed etiology (causes)
What are the common features of depressive disorders?
presence of sad, empty, or irritable mood
irritable can be depressive episode
What are depressive disorder features accompanied by?
What are some change examples?
can be accompanied by somatic and cognitive changes that significantly affect the capacity to function
Somatic changes: appetite, sleep, chronic pain
Cognitive changes: feeling hopeless
What are the differences between Female and Male cognitive changes?
Females feel more sadness; may loose motivation
Males feel more numbness
What is needed for criteria A?
5 or more of the 9 symptoms must have been present during the same 2 weeks with a change from previous functioning
one of the symptoms HAS TO BE depressed mood or loss of interest/pleasure
What are the 9 symptoms?
- depressed mood most of the day/almost every day
- markedly diminished interest or pleasure; numbness
- significant weight loss >5% in am month (NOT DIETING)/ increase or decrease of appetite
- insomnia or hypersomnia
- psychomotor agitation or retardation; immobility
- fatigue or loss of energy
- feeling worthless or excessive guilt
- can’t concentrate/indecisiveness
ex: because of rumination - recurring thoughts of death, suicide ideation w/o a plan, suicide attempt with a specific plan
What is needed for criteria B?
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
What is the prevalence of MDD in US adults?
What is the lifetime prevalence M vs. F?
What is the early adolescence prevalence difference in F v. M?
- 12 months; 7%
- M - 1 in 6; F 1 in 4
- females experience MDD 1.5x’s - 3x’s more
Which somatic symptoms were found in American and Japanese depressed patients?
- headache
- fatigue
- neck pain
- abdominal symptoms
- loss of appetite
- sleep issues
Which medical illnesses are linked to depression?
- diabetes
- cancer
- chronic pain
- heart disease
- autoimmune disease
- IBS
- hypothyroidism
- COPD
Why is there an overlap between brain regions related to depression and pain?
the nociceptive pathway for psychological pain includes some of the same brain structures from the affective-emotional pathway for physical pain
What are the overlapping brain regions between chronic pain and depression?
- anterior insula
- anterior cingulate cortex
- prefrontal cortex
- thalamus
- Additional research: amygdala and hippocampus
What are common neurotransmitters in chronic pain and depression?
serotonin
norepinephrine
glutamate
GABA
What is prescribed that has at least a moderate analgesic effect for pain conditions?
antidepressants
Which comes first, chronic pain or depression?
How can it be treated?
- chronic pain; depression is a response to the consequences of living with constant
pain - treatment: teach the idea to accept the pain and live a life
How does bereavement vary across races/ethnicities?
duration & expression
What depressive symptoms are present in bereavement?
What needs to be considered an exception within “normal” limits of bereavement?
excessive guilt
persistent thought of death
functional impairment
hallucinations
hearing or seeing someone could be normal
_____ is the __ leading cause of death in the US.
Suicide, 8th
Suicide is highly prevalent in what two races?
& in what age group?
What are the gender differences?
What are the 2 indices of suicidal behavior?
- white & native american
- youth
- males are more likely to complete; females are more likely to attempt
- suicidal attempts and ideations
What are 8 risk factors of suicide?
Suicidal thoughts with intent
Suicide in the Family
Low Serotonin/Norepinephrine Levels
Evidence of a Preexisting Psychological Disorder
Alcohol Use and Abuse
Past Suicidal Behavior
Experiencing of a Shameful/Humiliating Stressor
Publicity About Suicide and Media Coverage
What are the genetic influences of suicide in twin studies?
concordance rates are high in monozygotic twins (identical)
sever cases have stronger genetic contribution
heritability is higher for females
Which two neurotransmitters have a neurobiological influence in depression?
What increases in the endorcine system?
What disruption has a strong relationship to depression?
- Low serotonin & norepinephrine
- cortisol
- sleep; disrupted circadian rhythms
What increases and decreases because of low serotonin?
What decreases because of low norepinephrine?
What is presented by a patient in a depressive mood with altered 5HT & NE?
5HT: low sex drive and appetite, high aggression
NE: low concentration, interest, motivation
Depressed Mood: anxiety, irritability, slow/blocked thought process, vague aches and pain
According to Beck what is psychological influence of stress in mood disorders?
stress can start cognitive and biological processes that increase risk of a mood disorder
According to Kessler, what are the 2 best predictors of an onset of depression?
- major life events: loss of work, loved one, finances
- social rejection
Stress can induce ________ in the _________.
inflammation, immune system
What are cytokines?
Cytokines – proteins of the inflammatory response to stress; can cause more damage than the host pathogen itself
What are the 8 sickness behaviors induced by cytokines?
Anhendonia; anticipated loss of reward in pleasure
Anorexia
Hypersomnia; sleep too much
Hyperalgisias; sensitivity to pain/extreme response to pain
Malaise; feeling of discomfort, illness, or lack of well-being
Poor concentration
Social withdrawal
Weakness
What theory states: “lack of perceived control over life events”?
Learned Helplessness Theory of Depression
What are the three domains of Depressive Attributional Style?
What do they sum up to?
Internal attributions
Stable Attributions
Global Attribution
= Hopelessness
What are internal attributions?
believing all bad outcomes are your fault
“I failed because I am no good”
What are stable attributions?
believe all future bad outcomes will be your fault
“I will always fail”
What is global attribution?
believing they fail in many life activities
“I fail at everything”
What is Aaron T. Beck’s cognitive Theory of Depression?
Depressed persons engage in cognitive errors
A tendency to interpret life events negatively
What is Beck’s depressive cognitive triad?
think negatively about yourself, the future, and the world