Depressive Disorders

Question 1

Types of depressive disorders

Answer 1

•Disruptive Mood Dysregulation Disorder
•Major Depressive Disorder
•Persistent Depressive Disorder
•Premenstrual Dysphoric Disorder

Question 2

Used to be called dysthymia

Answer 2

Persistent Depressive Disorder

Question 3

Symptoms in this cluster of disorders include somatic and cognitive changes which typically affect an individual’s ability to function

Distinctions: severity, duration of episodes, degree of chronicity, and presumed etiology

Answer 3

Depressive D/O

Question 4

Major depressive disorder characterizes what two disorder

Answer 4

Bipolar and depressive disorders

Question 5

Diagnostic criteria for specific episodes are identical, regardless of the condition in which they appear.
•Distinction made based on frequency and duration of the episodes and whether or not accompanied by manic or hypomanic episodes.

Answer 5

Major depressive disorder

Question 6

For a dx of MDD an individual must

Answer 6

show 5 symptoms that include depressed mood or anhedonia and four other manifestations of depression

Question 7

Symptoms of MDD may include

Answer 7

–Weight loss without attempting to do so
–Insomnia or hypersomnia almost every day
–Fatigue or lack of energy
–Feelings of guilt or worthlessness
–Difficulty concentrating
–Repeated suicidal ideation

Question 8

Etiology of MDD

Answer 8

there is a genetic component although the precise characteristics of the genetic factors are not yet established.

Question 9

Prognosis of MDD

Answer 9

Outcomes will vary; some do well, experience few recurrences and better postepisode function and others have chronic and severe courses. More positive emotion is associated with better outcome

Question 10

Prognosis factors for recurrence of MDD

Answer 10

Severity of the episode and sever symptoms of depressed mood, intense sadness, and anorexia. Long working hours, work-family conflict, negative thinking, and co-existing social phobia

Question 11

combination of the characteristics of t DSM-4 conditions: chronic major depressive disorder and dysthymic disorder

Answer 11

Dysthymia

Question 12

Etiology, prognosis, and implications of dysthymia

Answer 12

Etiology: Unclear

Prognosis: relatively intractable

Implications: same as indicated for major depressive d/o

Question 13

5 or more symptoms before and during menses indicating Premenstrual Dsyphoric Disorder

Answer 13

emotional lability, irritability, depressed mood, anxiety, decreased interest in activities, poor concentration, lethargy, changes in appetite and sllep, feelings of being overwhelmed or out of control, and physical symptoms

Question 14

Etiology, prognosis, and implications of premenstrual dysphoric disorder

Answer 14

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

Question 15

What are Depressive Disorders?

Answer 15

They include:
•Disruptive mood dysregulation disorder
•Major depressive disorder
•Persistent depressive disorder (dysthymia)
•Premenstrual dysphoric disorder
•Substance/medication induced depressive disorder
•Depressive disorder due to another medical condition
•Other/Unspecified D.D.

Question 16

Common features of depressive disorders

Answer 16

Sad, empty, or irritable mood accompanied by

Somatic and cognitive changes that significantly affect individual’s capacity to function

Question 17

Depressive disorder in children

Answer 17

⦿Disruptive mood dysregulation – refers to presence of symptoms

Question 18

Prevalence of depressive disorders

Answer 18

⦿Common among children presenting to pediatric mental health clinics
⦿Among children and adolescents – 2% – 5% range
⦿Rates expected to be higher in males and school aged children than in females and adolescents.

Question 19

Development and course of depressive disorders

Answer 19

⦿Onset must be before age 10 and diagnosis should not be applied to children with a developmental age of less than 6.
⦿Diagnosis validity established for those aged 7 – 18 years

Question 20

Risk factors of depressive disorders

Answer 20

⦿Temperamental

⦿Genetic and physiological factors

Predominantly male children present to clinics with DMDD (disruptive mood dysregulation diorder)

Question 21

Functional consequences in depressive disorders

Answer 21

⦿Disruption in a child’s family and peer relationships and school performance
⦿Dangerous behavior, suicidal ideations or suicide attempts, severe aggression, and psychiatric hospitalization are common

Question 22

Depressed mood most of the day, nearly every day through subjective report or observation made by others (in children—it can be irritable mood).
•Diminished interest or pleasure in almost all activities most of the day, nearly every day

Answer 22

Major Depressive Disorder

Question 23

Risk factors of MDD

Answer 23

⦿Temperamental
⦿Environmental
⦿Genetic and physiological

Question 24

Functional consequences of MDD

Answer 24

Impairment can be very mild
⦿Impairment can range from complete incapacity (unable to attend to basic self-care needs or is mute or catatonic)
⦿In general medical environments, those w/major depressive disorders have more pain and physical illness and greater decreases in physical, social, and role functioning

Question 25

⦿Depressed mood for most of the day, for more days than not, for at least two years (in children and adolescents, mood can be irritable and duration must be at least 1 year)

Answer 25

Persistent Depressive Disorder (DYSTHYMIA)

Question 26

Development of PDD

Answer 26

Often has an early and insidious onset (childhood, adolescence, or early adult life) and a chronic course
⦿Early onset (before 21 years) is associated with higher likelihood of comorbid personality disorders and substance use disorders

Question 27

Risk factors of PDD

Answer 27

⦿Temperamental
•Several predictive factors (negative affect, symptom severity, poor global functioning, presence of anxiety disorders or conduct disorder)
⦿Environmental
•Parental loss or separation
⦿Genetic and physiological
•Brain regions implicated (prefrontal cortex, anterior cingulate, amygdala, hippocampus)

Question 28

Most common of all psychiatric disorders

Answer 28

Anxiety disorders

Question 29

unpleasant emotional, cognitive, behavioral, or physical experiences of stress

Answer 29

Anxiety

Question 30

worry that propels one to act

Answer 30

Normal anxiety

Question 31

feeling uneasy, overwhelmed, helpless and out of control

Answer 31

Emotional

Question 32

cardiovascular, gastrointestinal, respiratory, urinary, genital, autonomic, muscular

Answer 32

PHYSIOLOGICAL

Question 33

confusion, poor memory, loss of perspective, obsessive thoughts, poor problem solving

Answer 33

Cognitive

Question 34

looks preoccupied, immobile, overactive, restl

Answer 34

Behavioral

Question 35

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

4 or more symptoms in 10 minutes

Answer 35

Panic attack

Question 36

Prevalence of anxiety

Answer 36

Median age of onset fir anxiety disorders (11 years) younger than the age of onset for substance use (20 years) and mood disorders (30 years)
⦿GAD one of the most prevalent psych d/o documented in US

Question 37

Gender differences in anxiety

Answer 37

⦿Women at higher risk than men for anxiety d/o
⦿Gender specific risk factors for women:
•Socioeconomic disadvantage
•Gender-based violence
•Subordinate social status
•Responsibility for the care of others