Depressive disorders

Question 1

neurovegetative symptoms of depression

Answer 1

somatic complaints

Question 2

dysphoria

Answer 2

feeling sad/depressed/down

Question 3

anhedonia

Answer 3

lack of pleasure

Question 4

paradoxical suicide

Answer 4

committing suicide when symptoms are improving d/t increased energy to carry it out

Question 5

MDD with psychotic features

Answer 5

delusions/hallucinations
specify if mood-congruent or mood-incongruent

Question 6

MDD with melancholic features

Answer 6

depression w/ severe anhedonia, early morning awakening, weight loss, profound feelings of guilt

Question 7

MDD with catatonic features

Answer 7

stupor
blunted affect
extreme withdrawal
negativism
marked psychomotor retardation

Question 8

objective rating scales for depression

Answer 8

HAM-D (clinician-administered)
Zung (self-administered_
Raskin depression scale (both)

Question 9

focus of cognitive therapy

Answer 9

identify and test reality of negative cognitions and practice new cognitive and behavioral responses

Question 10

2 assumptions of interpersonal psychotherapy

Answer 10

1. current interpersonal problems originate from previous dysfunctional relationships
2. current interpersonal problems precipitate/perpetuate depressive symptoms

Question 11

the gist of behavioral psychotherapy

Answer 11

by identifying and addressing maladaptive behavior patients can learn to function in a way that gets them positive reinforcement

Question 12

goal of psychoanalytically oriented psychotherapy

Answer 12

change in personality structure/character for more than just to relieve symptoms

Question 13

aims of psychoanalytically oriented psychotherapy

Answer 13

-interpersonal trust
-capacity for intamacy
-coping mechanisms
-capacity to grieve
-ability to experience a wide range of emotions

Question 14

what is another term for dysthymic disorder

Answer 14

persistent depressive disorder

Question 15

sx of dysthymic disorder in relation to those of MDD

Answer 15

not as severe but often more chronic

Question 16

what is double depression

Answer 16

when criteria is met for both MDD and dysthymic disrder

Question 17

which type of medications are best to treat melancholic depressions

Answer 17

those that act dually on serotonin and norepinephrine

Question 18

what is considered a partial medication response

Answer 18

20-25% reduction in symptoms

Question 19

what is the effect of depression on the HPA axis

Answer 19

it is overactive leading to increased cortisol levels

Question 20

thyroid axis activity in depression

Answer 20

20-30% have blunted TSH response on challenge

5-10% have undiagnosed thyroid disorder

Question 21

what does BDNF stand for

Answer 21

brain-derived neurotrophic factor

Question 22

what does BDNF do

Answer 22

responsible for ongoing maintenance of neurons in the brain

Question 23

what happens when there is a disruption of BDNF in the brain

Answer 23

reduction in neuronal number and size

Question 23

agents that increase BDNF

Answer 23

antidepressants
estrogen
lithium
neurostimulation

Question 23

amygdala

Answer 23

a waystation for processing stimuli of emotional significance and coordinating/organizing cortical responses

Question 24

what is adjacent to the amygdala and associated with learning and memory

Answer 24

hippocampus

Question 25

What is L-sided activation of the PFC associated with

Answer 25

goal-directed or appetitive behavior

Question 26

what is right-sided activation of PFC associated with

Answer 26

avoidance behaviors and inhibition of appetitive pursuits

Question 27

which region of the brain is involved in attention, motivation, and environmental exploration

Answer 27

anterior cingulate cortex

Question 28

what structure in the brain regulated the HPA axis by inhibiting its activity

Answer 28

hippocampus

Question 29

what is the neurogenesis hypothesis of depression

Answer 29

chronic stress increases the activity of the HPA axis which increases glucocorticoid levels. glucocorticoids decrease neurogenesis. the hippocampus then cant regulate the HPA axis so glucocorticoids remain high and fewer neurons are produced leading to depression

Question 30

what is the neuroplasticity hypothesis of depression

Answer 30

neuronal atrophy causes depression rather than deficient growth. Atrophy is caused by increased glucocorticoid levels, which also decreases BDNF

Question 31

what are the 4 key points of the psychodynamic theory of depression

Answer 31

-disturbance in infant-mother relationship in the oral stage predisposes to depression vulnerability -depression can be linked to real/imagined object loss -unconscious thoughts of object as a defense mechanism to deal with distress connected to its loss -feelings of anger are directed inward because lost object is associated with mixture of love and hate

Question 32

what is the cognitive theory of depression

Answer 32

depression results from specific cognitive distortions in someone susceptible to depression

Question 33

Aaron Beck's cognitive triad of depression:

Answer 33

-views of self -views of environment -views of the future

Question 34

Triad of depression: views on self

Answer 34

tend to have a negative self-perception

Question 35

triad of depression: views on environment

Answer 35

tend to experience the world as hostile and demanding

Question 36

triad of depression: views of the future

Answer 36

tend to have expectations of suffering and failure