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Psychopathology > Depressive Disorders > Flashcards

Depressive Disorders Flashcards

1
Q

mania

A

abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week (or less if hospitalization required)

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2
Q

hypomania

A

abnormally and persistently elevated, expansive, or irritable mood lasting at least 4 days

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3
Q

euthymia

A

normal range of mood

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4
Q

dysthymia

A

chronically depressed mood that occurs most of the day more days than not for at least 2 years

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5
Q

major depression

A

at least 2 weeks with depressed mood or loss of interest/pleasure in nearly all activities

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6
Q

diagnostic criteria for major depressive episode

A 
at least 5 of these during 2 weeks:
SIGECAPS
Sleep (inc or dec)
Interest (loss of)
Guilt (or negative thoughts)
Energy loss
Concentration problems
Appetite (inc or dec)
Psychomotor activity (retardation or agitation)
Suicidal thoughts/ intent/ plan/ action
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7
Q

diagnostic criteria for major depressive disorder

A

2+ major depressive episodes separated by at least 2 months that aren’t better accounted for by other disorders
no hypo/mania
no alcohol, drugs, or medical condition
functional impairment

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8
Q

medical mimics of depressive symptoms

A

endocrinopathies (hypo or hyperthyroid, Cushing’s)
pancreatic cancer
chronic viral infection (HIV, HCV, CMV, EBV)
stroke (esp left side)
neuro dz (PD, MS)

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9
Q

substance-induced vs. primary mood disorder

A

substance-induced will resolve after 1 month of sobriety from substance

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10
Q

grief vs. major depressive episode

A

grief: gets better in 8 weeks, can have positive emotions, maintains self-esteem
MDE: persistent and pervasive unhappiness, self-loathing

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11
Q

prevalence of MDD, mean duration of MDEs, family history effect

A

F: 20%, M: 10%
MDE: avg 16 wks, longest episode avg 24 wks
FH: 2-4x higher if 1st degree family member diagnosed

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12
Q

MDD presentation in adolescents and elderly

A

kids more likely to be irritable than dysphoric

elderly deny mood changes but acknowledge anhedonia

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13
Q

risk factors for major depression

A

neuroticism, adverse childhood experiences (esp multiple of different types), family history

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14
Q

prognostic factors in MDD

A

increased likelihood of refractory course: comorbid illness, substance use, anxiety, borderline personality, DM, obesity, CVD

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15
Q

relapse rates of MDD

A

after 1 episode: 50%
2: 70%
3+: 80-90% - consider bipolar

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16
Q

“switch to bipolarity” in MDD patients

A

20-30% pts will experience manic episode later in life
drug-induced mania, hx postpartum depression (1st MDE), early onset MDD, sx hypomania, atypical features like psychomotor retardation, hypersomnia/ phagia - esp. bipolar 1

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17
Q

rates of suicide in MDD, alcohol dependence, SZ

A

MDD - 6%
EtOH - 7%
SZ - 4%

18
Q

risk factors for suicide

A

male >65, white or native American, prior attempt, psych d/o, chronic med condition, fam hx, chronic pain, substance abuse
recent extreme loss, exacerbation of psych/med disorder, impulsivity, access to firearms, high lethality plan

19
Q

factors increasing lethality of suicide attempt

A

lethality of means, access to means, extent/details of plan, attempt where unlikely to be discovered

20
Q

protective factors against suicide

A

marriage, religious affiliation, children in household, positive social support

21
Q

neurobiology of depression

A

? genetics, diet, environment –> dec 5HT and/or NE = inc receptors and inc transmission –> depression, anxiety, sleep disturbances, other physical signs
increased transmission of glucocorticoids/ bad stuff and less good stuff/BDNF

22
Q

theories of depression: psychoanalytic

A

d/t real or imagined loss of love object

23
Q

theories of depression: cognitive

A

perception of events –> negative view of self or world/others or future

24
Q

theories of depression: behavioral

A

lack of positive reinforcement d/t stopping enjoyable activities or doing unenjoyable ones

25
Q

theories of depression: learned helplessness

A

behavior doesn’t affect feelings

26
Q

theories of depression: attachment

A

don’t attach to security figure in development –> fear of exploring/ going out

27
Q

persistent depressive disorder (dysthymia): dx features

A

chronically depressed mood for most of day on most days for 2 years (1 year irritability in kids)
during: at least 2 of: dec/inc appetite, in/hypersomnia, low energy, low self-esteem, poor concentration or difficulty making decisions
feelings of hopelessness
impairment in social/ work/ school function
*no euthymia >2 months
*dx only if first 2 years have no MDEs

28
Q

double depression

A

dysthymia for 2+ years, then MDD on top of that

29
Q

course of dysthymia/ persistent depressive disorder

A

early and insidious onset, chronic
much less likely to resolve depressive sx vs MDE
inc risk of MDD (w/i 5 y), and MDE revert to dys- not euthymia

30
Q

risk factors for dysthymia

A

parental loss or separation

genetic: inc % 1st deg relatives with depressive d/os

31
Q

comorbidity risk in dysthymia

A

higher risk than MDD for:
anxiety d/o, substance use d/o
early onset: inc risk for cluster B and C personality d/o

32
Q

PMDD diagnostic criteria

A

for majority of menstrual cycles
1+ of: depressed mood, hopelessness, self-deprecation; anxiety or tension; affective lability; anger or irritability
1+ of: dec interest in activities; feeling of difficulty concentrating; lethargy
to total 5: change in appetite or cravings; hyper or insomnia; sense of being overwhelmed or out of control; physical sx (breast tenderness, jj/mm pain, “bloating”, wt gain)

33
Q

risk and prognostic factors for PMDD

A

hx interpersonal trauma

use of oral contraceptives lowers sx

34
Q

first line tx for depressive disorders

A

SSRI, SNRI, bupropion, TCAs, MAOIs, etc.

35
Q

neurotransmitters and sx of depression

A

5HT: obsessions, compulsions, mood, anxiety
NE: alertness, energy, mood, anxiety
DA: attention, pleasure, reward, motivation, mood

36
Q

CBT

A

cognitive behavioral therapy identifies negative thoughts that affect mood

37
Q

IPT

A

interpersonal therapy addresses relationship difficulties

38
Q

psychoanalysis

A

oriented insight reserved for higher functioning adults

39
Q

family therapy

A

for difficulties at home

40
Q

ECT

A

eletroconvulsive therapy for refractory cases or psychotic episodes
very effective with minimal side effects like temporary memory impairments

41
Q

rTMS

A

repetitive transcranial magnetic stimulation
non-invasive, targets neuronal circuitry implicated in neuropsych disorders
not as effective as ECT

42
Q

consequences of failing to achieve remission of depressive symptoms

A

increased risk short-term relapse
increased risk long-term chronic course
poor social functioning

Psychopathology (7 decks)

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