Lecture 5 'Mood Disorders'

Question 1

According to the APA, what is the definition of mood?

Answer 1

A pervasive and sustained emotional response that can colour perception

Question 2

What is the leading cause of disability world wide?

Answer 2

Depression

Question 3

What are the types of bipolar and related disorders?

Answer 3

Bipolar disorder =
> Bipolar I (Manic, Depressed, Hypomanic, Unspecified) or
> Bipolar II or
>Cyclothymia

Question 4

What is the difference between a manic episode and a hypomanic episode?

Answer 4

Manic = distinct period of abnormally and persistently elevated mood / goal-orientated activity for at least one week

Hypomanic = not as severe (lasts only for four consecutive days)

Question 5

What are the differences between Bipolar I and Bipolar II?

Answer 5

Bipolar I > most recent episode can be hypomanic, manic, depressed or unspecified

Bipolar II > one or more MAJOR DEPRESSIVE episodes accompanied by at least one HYPOMANIC episode (NEVER had manic episode)

Question 6

What is cyclothymic disorder?

Answer 6

Mild form of bipolar disorder.

Depressive, manic or hypomanic episodes never met criteria but person still shows less severe symptoms

Gradual onset; affects females more 3:2

Question 7

What are the common psychiatric disorders to consider when determining the differential diagnosis for bipolar disorder?

Answer 7

Schizophrenia
Personality Disorders (borderline, narcissistic, histrionic)

Question 8

Bipolar disorder often starts with _____________. The age of onset is between __ to __ years. Over time, the amount of time between episodes often ______.

Answer 8

depression
18-22 years
decreases (cycling becomes quicker)

Question 9

What are four indicators of a good bipolar prognosis?

Answer 9

> Short duration of manic episodes
Older age of onset
Few suicidal thoughts
Few co-existing psych/med problems

Question 10

What are the types of depressive disorders?

Answer 10

• disruptive mood dysregulation
• major depression (single or recurrent)
• persistent depression
• premenstrual dysphoria

Question 11

The risk of suicide in both unipolar and bipolar is ___% or __ times that of the risk in the general population

Answer 11

15

30x

Question 12

Jane has been diagnosed with persistent depressive disorder. This means her symptoms must have been present for how long? Which exclusionary criteria must she have met?

Answer 12

> Present for at least two years (one year for adolescents)

> Never met manic episode, hypomanic or cyclothymic (or substance/medical condition)

Question 13

True or False. Major depressive disorder (MDD) CAN NOT be present in persistent depressive disorder

Answer 13

False - it can be present for two years

Question 14

What underlying dimension may be common for depressive symptoms and anxiety symptoms?

Answer 14

they both share the underlying dimension of negative affect but it manifests differently

Question 15

Major Depressive Disorder is fundamentally a ______ disorder

Answer 15

cyclic

Question 16

What factors increase the risk of major depressive disorder recurrence

Answer 16

> History of more than one previous depressive episode

> Co-existing: dysthymia alcohol/drug abuse, anxiety symptoms

Question 17

For depression, prospective studies highlight events involving ______ and suggest _____ ______ is linked to relapse.

Answer 17

Loss

Expressed emotion

Question 18

For bipolar disorder, attributional styles and dysfunctional attitudes interact with intervening ____ _____? Family discord predicts what kinds of outcomes?

Answer 18

life events

Poor short-term outcomes

Question 19

According to Freud, depression is a reaction to the loss of an ______/_____ held object. Depression reflects internalized _______ impulses

Answer 19

unconsciously / ambivalently

aggressive

Question 20

According to the behavioural model for depression, what three ways might insufficient reinforcement occur? Give an example for each

Answer 20

1. Environment produces a loss of reinforcement (e.g. loss of job)
2. Lack of requisite skills (e.g. poor social skills won’t get social reinforcement)
3. Unable to enjoy or receive satisfaction from reinforcement (e.g. anxiety)

Question 21

According to the Learned Helplessness model, the more ________, _______ and _______ the attributions about negative life events, the more likely depressive symptoms are to occur.

Answer 21

personal
stable
global

Question 22

Describe the three Helplessness theories of depression.

Answer 22

1. Learned helplessness:
   Uncontrollable aversive event&raquo_space; Sense of helplessness&raquo_space; Depression
2. Attributional Reformulation
   Aversive events&raquo_space; Personal + Global + Stable factors (cognitions)&raquo_space; Sense of helplessness&raquo_space; Depression
3. Hopelessness
   Aversive events&raquo_space; Personal + Global + Stable factors (cognitions)&raquo_space; Sense of helplessness and expectation that desirable outcomes will not occur&raquo_space; Depression

Question 23

Describe Beck’s (1979) Cognitive Triad of depression?

Answer 23

> Negative triad (pessimistic view of self/world/future)
Negative schema/beliefs (triggered by negative life events)
Cognitive biases
Depression

Question 24

What is Beck’s Negative Triad?

Answer 24

Negative views about:

Oneself
The World
The Future

Question 25

Describe the interpersonal theory of depression and bipolar?

Answer 25

People with those disorders are more likely to have social deficits - cause or effect?

Question 26

The biological model of mood disorders indicates that genetics plays a role in its aetiology, what evidence supports this?

Answer 26

Higher freqency of mood disorders among relatives of bipolar probands than unipolar depressed probands

Most have a family history of the disorder

Question 27

Classical twin studies indicate that bipolar and depression have _______ infuences

Answer 27

polygenic influences

Question 28

According to the Catecholamine hypothesis, too much of the drug __________ may cause mania, too little may cause depression.

Answer 28

noradrenaline

Question 29

The deficiency in serotonin may be related to depression. This hypothesis is called what?

Answer 29

Indolamine hypothesis

Question 30

What are two limitations of neurochemical models to explain mood disorders?

Answer 30

1. complex inter-relationships between neurotransmiters and other biological systems preclude a simple deficit model
2. A simple biochemical deficit/excess model cannot account for a heterogeneous disorder like depression which involves a dysregulation of many functions

Question 31

What category of antidepressants is the most commonly used for treatment?

Answer 31

Selective serotonin reuptake inhibitors (SSRIs)

Question 32

When is electro-convulsive therapy used to treat depression?

Answer 32

> When there are prominent psychotic/melancholic features
Meds haven’t worked
Life-threatening situations
Prior positive reponse to ECT

Question 33

What is the standard drug for treatment of manic episodes and cyclothymia?

What are other psychological therapies for bipolar disorder?

Answer 33

Lithium

• Group therapy
• Psychoeducation
• Family therapy
• CBT
• Interpersonal therapy

Question 34

What are the two main psychological therapies for the treatment of depression? How do they compare with medication?

Answer 34

CBT and Interpersonal Relationship Therapy

Both as effective as each other, and as effective as medication