Depressive Disorders Flashcards

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1
Q

Emotional Symptoms of MDD

A

depressed mood
- emptiness, hopelessness, distress or feeling disappointed or disgusted at oneself, worthlessness or excessive, inappropriate guilt

anhedonia (diminished interest or pleasure in all, or almost all, activities)
- more common than depressed mood
- reduced positive feeling, fun activities may not help

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2
Q

Cognitive Symptoms of MDD

A
  • recurrent thoughts of death, suicide ideation, a specific plan for committing suicide or a suicide attempt
  • diminished ability to think, concentrate or make decisions
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3
Q

Physical/Somatic Symptoms of MDD

A
  • significant changes in appetite or weight without trying
  • insomnia or hypersomnia
  • psychomotor agitation (feeling jittery)
  • fatigue or loss of energy
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4
Q

Prior Name for PDD

A

Dysthymia

  • changed due to the inclusion of chronic features of MDD and the dysthymic disorder
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5
Q

PDD

A
  • depressed mood
  • experience fewer symptoms of MDD

experience at least two of symptoms: appetite changes, insomnia/hypersomnia, fatigue, low self-esteem, poor concentration/difficulty making decisions, hopelessness

  • occurs on most days for period of at least 2 years
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6
Q

Depression Causes

A

environmental
- stress (general or life stressors)
- low socioeconomic status, substance abuse and comorbid mental disorders
- gender,

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7
Q

Extent of Mania in PDD and MDD

A

never occurs, there has been many misdiagnoses of bipolar disorders due to the struggle to monitor mania, as people with it often go to psychologists when they aren’t experiencing it.

many people are often diagnosed after hospitalisation

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8
Q

Mania

A

abnormally elated, euphoric and may also feel irritable and distractable

manic episodes often have people feeling on top of the world, hyper confident

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9
Q

Bipolar I Disorder

A

most associated with mania, resulting in hospitalisations or interference with the person’s functioning at work or their relationships

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10
Q

Bipolar II Disorder

A

most associated with hypomanic episodes, causes less impairment and has less severe symptoms

hypomanic episodes are the same as mania but less intense, episodic/ happens in spurts

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11
Q

Beck’s Cognitive Model of Depression

A

thought errors by depressed people negatively focused in three areas:
- themselves
- their immediate world
- their future

negative schemas and appraisals can contribute to the development and maintenance/continuation of depression

  • depressed people hold a negative self-schema
  • requires negative schemas to be actuated after a person experiences significant life stressors
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12
Q

Attention Bias

A

phenomenon whereby people with depression are more likely to turn their attention to sad faces

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13
Q

Memory Bias

A

phenomenon whereby people are more likely to remember negative events and interpret neutral events as being negative

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14
Q

Rumination

A

a repetitive, cyclic pattern of negative thinking where similar thoughts get recycled over and over
- characteristic thought patterns of depression

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15
Q

Joint Attention

A

tendency to direct gaze to the location of someone else’s gaze
- lack of this may stem from a difficulty to trust, struggles to maintain friendships and social support

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16
Q

Study on Joint Attention

A

people are faster at correctly categorising an object when it was preceded by a face gazing towards the object’s direction

  • they also rated these helpful faces as being more trustworthy even though none of the participants knew that the direction of those faces’ gaze predicted the location of the object they needed to categorise
  • however depressed people didn’t classify the same trustworthiness despite doing the same task
17
Q

Maintenance Factors

A
  • serotonin
  • norepinephrine
  • dopamine
18
Q

Serotonin

A

regulates mood via relationship with other neurochemicals (norepinephrine and dopamine)

  • low serotonin levels dysregulates other neurochemicals, making mood fluctuate
19
Q

Dopamine

A

regulates emotion, hunger and high cognitive functions like self-regulation, impulse control, motivation, planning and psychomotor movement

  • these can be disrupted with depression
  • role of reward and learning: when chronic stress downregulates, dopaminergic system tries to counteract it, taking away its activity in other pleasure-inducing situations
20
Q

SNRIS (Serotonin-Norepinephrine Reuptake Inhibitors)

A

chronic stress downregulates norepinephrine system

  • blocks the reuptake of serotonin and norepinephrine
  • restricting the fluctuation of other neurotransmitters, thus stabilising mood (like SSRIs)
  • adrenaline gets released as part of fight or flight response and with exposure to long-term stress the body eventually can’t manufacture enough norepinephrine to keep up demand
  • this is compensated for by reducing norepinephrine activity
21
Q

Learned Helplessness

A

anxiety and depression when attributing their lives to a lack of control what makes them feel stress

  • animals repeated and prolonged exposure to conditions out of their control
  • disrupts norepinephrine systems in similar way to what is seen in humans
  • Seligman
22
Q

Thought Errors

A

disordered thinking habits

Includes:
- black and white thinking (polarising opinions)
- catastrophising (taking to extremes)
- generalisation
- mind reading (assuming others speak badly on them)
- fortune telling (perceived understanding of future with no evidence)
- emotional reasoning

23
Q

CBT

A

challenges incorrect assumptions/thought errors and replaces with more realistic ones

24
Q

Behavioural Activation

A

where the person schedules and then engages in a range of activities
- action prevents person from engaging in safety behaviours
- gives agency and sense of self-control
- works in similar way to antidepressants by increasing levels of serotonin and dopamine

25
Q

MAO Inhibitors (Monoamine Oxidase Inhibitors)

A

prevents neurotransmitters from being broken down, alters brain chemistry
- large adverse effects

26
Q

Interpersonal Psychotherapy (IPT)

A
  • teaches people the social skills needed to resolve problems in interpersonal relationships
  • empower the person by addressing deficits
27
Q

Electroconvulsive Therapy (ECT)

A
  • high risk depression may require ECT
  • associated with some short-term memory loss for couple of days after therapy
  • might cause structural changes, like helping new brain cells grow or increasing levels of serotonin and blocking effect of stress hormones
28
Q

Transcranial Magnetic Stimulation (TMS)

A
  • electromagnetic coil placed on head and small, focused pulse in delivered to part of the brain
  • doesn’t need anaesthesia and mild side effects
  • doesn’t work as well in patients with severe treatment resistant depression
29
Q

black and white thinking (thought error)

A

polarising opinions

30
Q

catastrophising (thought error)

A

taking to extremes

31
Q

generalisation (thought error)

A

making broad statements when they may not be apply specifically

32
Q

mind reading (thought error)

A

assuming others speak badly on them

33
Q

fortune telling (thought error)

A

perceived understanding of future with no evidence

34
Q

emotional reasoning (thought error)

A

failure to use logic, third-party thought

35
Q

Antidepressants prior to SSRI’s/SNRI’s

A

most commonly prescribed tricyclic depressants, including imiprimine

  • prevented the reuptake of norepinephrine and serotonin
  • stopped being used because of weight gain, blurred vision, constipation, difficulty urinating and dry mouth
36
Q

5HTT Gene

A

serotonin transporter gene

some people have
- two short alleles
- two long alleles
- one of each

people with two copies of short allele are more likely to develop depression after a stressful life event like trauma in childhood or losing a loved one

37
Q

Double Depression

A

PDD and MDD