Lecture 5: Depressive Disorders Flashcards
what is common between unipolar and bipolar?
The depressive episode is the same.
What types of unipolar disorders in DSM IV?
Major Depressive Disorder, Dysthymic Disorder
What characterises the manic episode?
abnormally elevated mood
Including 3 or more of: inflated self-esteem, grandiosity, decreased need for sleep, increased talkativeness, distractibility, flight of ideas, increased goal-directedness, excessive pleasure seeking
What are the different types of Bipolar disorders? describe them.
Bipolar I Disorder, full blown manic episode
Bipolar II Disorder, hypo manic episode
Cyclothymic Disorder, the dysthymia of bipolar i.e. mild disorder
How are the disorders different with DSM - 5
Major Depressive Disorder
Persistent Depressive Disorder
(Dysthymia)
These are both in a separate section to bipolar
how do you diagnose Major Depressive Disorder?
One or more major depressive episodes.
Depressed mood most of the day, nearly every day
Markedly diminished pleasure/interest in activities
Significant weight loss or gain
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day
Fatigue/loss of energy nearly every day
Feelings of worthlessness, excessive guilt nearly every
day
Diminished ability to concentrate nearly every day
Recurrent thoughts of death, suicide, suicide attempts
5 or more is needed, (including 1/ or 2/) in a 2-week
period
what three groups of symptoms of MDD are there? describe them
Affective symptoms:
Depressed mood, anhedonia (loss of pleasure)
Cognitive / motivational symptoms:
Indecisiveness, lack of concentration, lack of interest
Somatic symptoms:
fatigue, sleep or appetite changes
What is to note about recurring episodes for MDD?
Single or recurrent depressive episode, not accounted for byother disorders
Recurrent episodes are common
how would you diagnose Dysthymia (A-E)
A. Depressed mood for most of the day, for more
days than not, for at least 2 years.
B. Presence, while depressed, of two (or more) of:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
C. No more than 2 months ‘normal’ mood in 2-years
D. No Major Depressive Episode during the first 2
years
E. No manic features
Symptoms are milder but longer lasting than Major Depression
Symptoms can persist unchanged for long periods (e.g., decades)
May also develop Major Depression
What to note about prevalence of major depression?
Twice as common in women than it is in man
In children same number of boys and girls diagnosed.
However shoots up in adolescence in women. Remains through life. Evens out in old age (65)
Age of onset younger and prevalence higher of diagnosis of younger generations compared to older generations
What 3 aspects of biological theories are there? describe them.
Genetic vulnerability
Heritability: 35-60 percent
Heredity creates a vulnerability to mood disorders
No evidence for specific genes
Neurochemistry
Low levels of Noradrenalin and/or Serotonin
No good evidence for mechanism
Neuroendocrine System
Excess cortisol in response to stress
Increased stress is strongly related to mood disorders
what is important to note about the biological theories
Genetic vulnerability
- Heritability depends on the severity of depression and the actual diagnosis. Bipolar is a lot more heritable than unipolar.
- Not a specific disorder gets passed down. Instead it is a tendency to become neurotic (negative affect). I.e. not a specific depression gene
Neurochemistry
- Serotonin can be involved in causation or maintenance
- know the chemicals are involved just don’t know the mechanisms
Neuroendocrine (neurotransmitters and hormones)
- Humans are good at dealing with short stress, but not chronic long term stress.
give an equation with how depression obtains with the biological explanation. what is important to note?
Biological Vulnerability + Stress => Depression
NB: Higher the genetic vulnerability, the less stress is needed to result in depression. And vice-versa.
give an equation with how depression obtains with the psychological explanation
Cognitive Vulnerability + Stress => Depression
Explain the schema psychological theory.
Pre-existing negative schemas
Activated by stress
Result in information processing biases:
Biased attention, memory, interpretations
Negative thoughts become dominant in consciousness
distorted view of self, world, future
–> Underlying belief when there is a stress consistent with core belief.
Similar thinking in similarly disordered people.
One of the most important risk factor is a depressed parent.
