Depressive Disorders Flashcards
Disruptive Mood Dysregulation Disorder is diagnosed in the presence of:
- Severe recurrent verbal or behavioral _____________ outbursts grossly out of proportion to the _____________,
- A chronic, persistently irritable/angry mood between outbursts on most days
- Symptoms persist at least ____________ and are exhibited in at least ___ of ___ settings,
- Outbursts are inconsistent with the individual’s developmental level and occur, on average, ___ times per week.
- Temper
- Provocation
- 2 weeks
- 2 of 3
- 3
A diagnosis of Disruptive Mood Dysregulation Disorder cannot be diagnosed before the individual is at least ___ years of age or after he/she is ___ years of age, and age of onset must be before age ___.
- 6
- 18
- 10
A diagnosis of Major Depressive Disorder requires the presence of at least ___ symptoms of a major depressive episode nearly every day for at least __________, with at least one symptom being depressed mood or loss of interest/pleasure (or, in children and adolescents, a depressed or irritable mood).
- 5
- 2 weeks
Symptoms of a major depressive episode include:
- Depressed mood
- Diminished interest/pleasure in most activities
- Significant changes in ____________ and/or ____________
- Insomnia or hypersomnia
- Psychomotor ___________ or __________
- Fatigue/energy loss
- Feelings of ___________ or excessive _________
- Diminished ability to think/concentrate
- Recurrent thoughts of death
- Recurrent suicidal ideation
- Suicide attempt
- Weight
- Appetite
- Agitation
- Retardation
- Worthlessness
- Guilt
Specifiers for MDD address severity, course, and accompanying features. The latter include with _____________ features, with atypical features, with _________ onset, and with _____________ pattern.
- Psychotic
- Peripartum
- Seasonal
The specifier of with peripartum onset is applied to MDD, Bipolar I, and Bipolar II when the onset is during pregnancy or within _______ postpartum.
4 weeks.
Depression with peripartum onset is often characterized by __________, preoccupation with the infant’s well-being, and (in extreme cases) _____________ about the infant.
- Anxiety
- Delusions
About ___ to ___% of women experience depression either during pregnancy or in the first several months after giving birth, while ___ to ___% develop postpartum psychosis.
- 10 to 20%
- .1 to .2%
“Baby blues,” characterized by mild transitory mood symptoms, affects up to ___% of women during the first ____________ following delivery.
- 80
- 2 weeks
The specifier, with seasonal pattern, is applied to MDD, Bipolar I, and Bipolar II Disorder when there is a ______________ relationship between the onset of a mood episode and the _______________.
- Temporal
- Time of year
Mood fluctuations corresponding to changes in time/season is also known as __________________ (SAD), and occurs most often in the ______________ in the Northern Hemisphere.
- Seasonal Affective Disorder
- Winter
SAD is associated with _______________, increased appetite and weight gain, and craving for _____________.
- Hypersomnia
- Carbohydrates
SAD has been linked to increases in ____________ levels, a phase-delay in _______________, and ________________ dysfunction.
- Melatonin
- Circadian rhythms
- Serotonergic
EEG abnormalities during sleep are experienced by ___ to ___% of outpatients experiencing a major depressive episode.
40 to 60%.
____% of people with MDD experience anxiety during their lifespan.
60%.
According to the DSM-5, the 12-month prevalence rate for MDD in the U.S. is about ___%, with marked age-related differences:
- The prevalence for individuals 18-29 is ___ times that of individuals 60+
- Prior to puberty, rates are ________ between males and females
- Beginning in early adolescence, the rate of MDD for females is ___ to ___ times the rate for males.
- 7%
- 3
- Equal
- 1.5 to 3
The peak age of onset of MDD is the ________, with variable course duration and number of episodes.
Mid-20s.
MDD symptoms vary somewhat with age:
- In children, somatic complaints, ___________, and social withdrawal are common
- In preadolescents (esp. boys), _____________ and destructiveness sometimes occur
- In older adults, memory loss, _____________, disorientation, and other cognitive symptoms may be present
- Irritability
- Aggressiveness
- Distractibility
Concordance rates for MDD:
- Monozygotic twins:
- Dizygotic twins:
- MDD is ___ to ___ times more common among first-degree biological relatives of individuals with the disorder than the general population.
- .50
- 0.20
- 1.5 to 3.0
Research has also supported a link between MDD and the personality trait ________________.
Neuroticism.
According to the __________________, some forms of depression are due to a deficiency in norepinephrine.
Catecholamine Hypothesis.
According to the ___________________, depression is the result of low levels of serotonin.
Indolamine hypothesis.
Depression has also been linked to elevated levels of _______________, which causes atrophy of neurons in the hippocampus; there is evidence that the total duration of untreated depression correlates with the amount of _____________ of the hippocampus.
- Cortisol
- Shrinkage
Lewinsohn’s (1974) Behavioral Theory of Depression is based on the principles of ________________, and attributes the disorder to a low rate of ________________ reinforcement for social and other behaviors, resulting in extinction of those behaviors and pessimism, low self-esteem, social isolation, and other features of depression.
- Operant conditioning
- Response-contingent
Seligman’s (1978) Learned Helplessness Model describes depression as the result of prior exposure to uncontrollable _____________ coupled with a tendency to attribute those events to internal, ____________, and stable factors.
- Negative events
- Global
Bonus: A more recent version of the model de-emphasizes attributions and describes hopelessness as the proximal and sufficient cause of depression.
According to Rehm’s (1987) Self-Control Model, depression is the result of a combination of problems related to _________________, self-evaluation, and ________________.
- Self-monitoring
- Self-reinforcement
Beck’s (1976) cognitive theory views depression as being related to negative, illogical self-statements about ____________, _____________, and _______________ (the “depressive cognitive triad”).
- Self
- World
- Future
Bonus: Some studies confirm Beck’s hypothesis; others suggest that negative beliefs may actually reflect a more accurate awareness of reality.
_______________ appear to be most effective for “classic depression” involving vegetative symptoms, worsening of symptoms in the morning, acute onset, short symptom duration, and moderate severity.
Tricyclics (TCAs).
_________________ are considered the first-line drug treatment for moderate to severe depression, and have fewer side effects and a lower risk for fatal overdose than ___________.
- SSRIs
- TCAs
_________________ may be beneficial for individuals who do not respond to ________ or _________ and/or who have atypical symptoms.
- Monoamine Oxidase Inhibitors (MAOIs)
- TCAs
- SSRIs
Venlafaxine (Effexor), desvenlafaxine (Pristiq), and duloxetine (Cymbalta) are _______________, increasing the levels of both ____________ and serotonin; there is evidence that they are comparable to TSAs in terms of effectiveness but differ in terms of side effects.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
- Norepinephrine
Research to date supports that a combination of _______________ and ________________ are better for depression than either modality alone, but ____________ is associated with a lower risk for relapse than ____________.
- Pharmacotherapy
- CBT
- CBT
- Pharmacotherapy
__________ has been found to be very useful for very severe, endogenous forms of depression that involve delusions or suicidal ideation or that have not responded to antidepressants.
Electro-convulsive therapy (ECT).
Bonus: Negative side effects (e.g., temporary retrograde/anterograde amnesia) may be reduced by administering ECT unilaterally to the right (nondominant) hemisphere).
Persistent Depressive Disorder (formerly known as Dysthymia) is characterized by a depressed mood (or in children, a depressed or _________ mood), on most days for at least ___________ in adults or at least ____________ in children and adolescents, as indicated by two of the following symptoms:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy/fatigue
- Low self-esteem
- Difficulty concentrating or making decisions
- Feelings of hopelessness
- The patient has not been symptom free for more than ______________, and Sx cause distress/impaired functioning.
- Irritable
- 2 years
- 1 year
- 2 months
Treatment of PDD often includes a combination of _______________ and either CBT or _____________ therapy.
- Antidepressants (esp. SSRIs)
- Interpersonal therapy
A diagnosis of Premenstrual Dysphoric Disorder (PMDD) requires symptom onset during the week before menses, improvement in symptoms within ________ of menses onset, and absence of or minimal symptoms during the __________ post-menses.
- A few days
- Week
A diagnosis of PMDD requires the presence of at least ___ characteristic symptoms; one of the symptoms must be:
- Marked affective _________
- Depressed mood or self-deprecating thoughts
- Anxiety or ____________
Additionally, at least one symptom must be:
- Decreased interest in _____________
- Impaired concentration
- Lethargy
- Marked change in ____________
- Hypersomnia or insomnia
- A sense of being overwhelmed/out-of-control
- Physical symptoms (e.g., ___________, joint/muscle pain)
- 5
- Lability
- Tension
- Usual activities
- Appetite
- Breast swelling/tenderness
