Exam 2: Mood and Depressive Disorders

Question 1

BPD 1

Answer 1

Full-blown maina w/ episodes of major depression

Onset age= 18 y/o

Question 2

BPD 2

Answer 2

At least 1 hypomania and 1 depressive episode

Age onset= 20 y/o

Question 3

Rapid-Cycling BPD

Answer 3

4+ severe mood disturbances in 1 year

Question 4

Mixed state BPD

Answer 4

Simultaneous mania & depression

Question 5

Cyclothymic Disorder

Answer 5

Fluctuations that alternative btw. hypomanic and depressive symptoms

Question 6

BPD Developmental Factors

Answer 6

Kids- rate diagnosis increasing overtime, may cycle more rapidly, irritability, temper tantrums –> push for Disruptive Mood Dysregulation D/O to not overdiagnose children

Question 7

Major Depressive Disorder (MDD)

Answer 7

Persistent sad/low mood

-Children may present with irritability or hostility

Question 8

Atypical Depression

Answer 8

Temporary boost in mood in response to positive events

Question 9

Persistant Depressive Disorder (Dysthymia)

Answer 9

Chronic state of depression that is milder than MDD, but persists longer
-Symptoms last 2+ yrs

Question 10

Disruptive Mood Dysregulation Disorder

Answer 10

Severe recurrent temper tantrums out of proportion in intensity/duration to situations.

-Ages 6-18 y/o
(may get another diagnosis when age out)
-Made to decrease rate BPD diagnosis in kids
-Must occur in more than one context

-New to DSM 5

-Alternative to BPD diagnosis for kids

Criticisms for BPD diagnosis in kids: Most children that meet criteria also meet criteria for other disorders (e.g., conduct disorders), poor reliability, might misdiagnose and be developmental issue

Question 11

Peri-pardum Depression

Answer 11

“Baby Blues”
Major depressive episode during, before, or after pregnancy

-onset (ex: post-partum) is specifier

-Similar to MDD
-May feel overwhelmed, emptiness, disconnect from child, guilt don’t feel overwhelming love for child after delivery

Result–>Associated w/ tempermental, behavioral, social, emotional, cognitive, and physical health difficulties in their kids

Question 12

Premenstrual Dysphoric Disorder (PMDD)

Answer 12

More extreme PMS,
Mood symptoms that include deep saddness, dispair, anxiety, anger/irritability, panic
-Symptoms persistent, not cyclical
-Changes in sleep, appetite, and labido may also occur

Question 13

Epidemiology/Sex of Mood/Depressive Disorders

Answer 13

MDD most common disorder in the US
-Depression rates 2x high for women
-Women at higher risk:
low SES, less educated, unemployed

Sex difference explanations:
-Hormones
-Bodily changes during puberty

Question 14

Cultural Influences on Depressive Disorders

Answer 14

Ethnic identity and religion can act as protective factors

-Culture may affect presentation and diagnosis

Question 15

Developmental Factors Depressive Disorders

Answer 15

Mean age onset MDD = 26 y/o

-Children/Young individuals may not have the words to describe emotions, so harder to diagnose earlier
-Childhood- boys and girls equally as likely to have depression
-Onset of puberty, sex differences emerge

Question 16

Depressive Disorder Comorbidities

Answer 16

72% comorbidity

Co-occurs with:

Anxiety d/o
Substance Use Disorder (SUD)
Impulse control d/o

-Depression most common comorbid disorder in eating disorder (eating d/o increases suseptibility)

Question 17

Suicidal ideation

Answer 17

Thoughts of death

Question 18

Active suicidal ideation

Answer 18

Includes details on a plan like when, where, and how

Question 19

Passive suicidal ideation

Answer 19

Wish to be dead with no active planning component

Question 20

Parasuicides

Answer 20

Acts that cause harm (like superficial self-harm or ODs on non-lethal meds) but do not lead to death

Question 21

Suicide victims

Answer 21

Males slightly more likely to commit suicide

Adolescent risks: MDD, BPD, previous attempts, drifting (feeling disconnected from work, home, family)

-Immediate events: relationship breakup, interpersonal problems, financial difficulties

Suicidal ideation and attempts higher in children and adolescence

90% children who die by suicide have a psych disorder

Question 22

Risk Factors in suicide

Answer 22

Previous attempts
Family history
Psychiatric illnesses
Biological factors (serotonergic system dysfunction)

Question 23

Etiology: Biological Perspective of BPD and MDD

Answer 23

-Genetic and family studies suggest heritability

-Neuroimaging studies –> brain abnormalities affecting emotional response/decision regulation, etc.

-Environmental factors: Stress, loss, grief, work problems
-Sensitivity to environment can influence genetic predisposition

Question 24

Etiology: Psychological Perspective of BPD and MDD

Answer 24

Psychodynamic theory
-Depression form of “anger turned inwards”
-Occurs after real/imagined loss

-Mania and depression are interlinked b/c mania is a defense to intolerable feelings of depression

Attachment theory
-Disruptions in attatchment leads to vulnerability to depression

Question 25

Etiology BPD MDD

Answer 25

Behavioral theories –> withdrawal of reinforcement for healthy behavior

Question 26

Treatment of BPD

Answer 26

Primary treatment medication

CBT
-effectiveness inconsistent in those w/ BPD
-responsiveness to reason may be impacted by mania

Question 27

Treatment of Depressive Disorders

Answer 27

-CBT
-Behavioral activation component (increase engagement in pleasurable activities to increase positive reinforcement)
-Interpersonal Psychotherapy

Biological treatments:
Antidepressants
Light therapy, ECT