Lecture 5 'Mood Disorders' Flashcards
According to the APA, what is the definition of mood?
A pervasive and sustained emotional response that can colour perception
What is the leading cause of disability world wide?
Depression
What are the types of bipolar and related disorders?
Bipolar disorder =
> Bipolar I (Manic, Depressed, Hypomanic, Unspecified) or
> Bipolar II or
>Cyclothymia
What is the difference between a manic episode and a hypomanic episode?
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)
What are the differences between Bipolar I and Bipolar II?
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)
What is cyclothymic disorder?
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
What are the common psychiatric disorders to consider when determining the differential diagnosis for bipolar disorder?
Schizophrenia Personality Disorders (borderline, narcissistic, histrionic)
Bipolar disorder often starts with _____________. The age of onset is between __ to __ years. Over time, the amount of time between episodes often ______.
depression
18-22 years
decreases (cycling becomes quicker)
What are four indicators of a good bipolar prognosis?
> Short duration of manic episodes
Older age of onset
Few suicidal thoughts
Few co-existing psych/med problems
What are the types of depressive disorders?
- disruptive mood dysregulation
- major depression (single or recurrent)
- persistent depression
- premenstrual dysphoria
The risk of suicide in both unipolar and bipolar is ___% or __ times that of the risk in the general population
15
30x
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?
> Present for at least two years (one year for adolescents)
> Never met manic episode, hypomanic or cyclothymic (or substance/medical condition)
True or False. Major depressive disorder (MDD) CAN NOT be present in persistent depressive disorder
False - it can be present for two years
What underlying dimension may be common for depressive symptoms and anxiety symptoms?
they both share the underlying dimension of negative affect but it manifests differently
Major Depressive Disorder is fundamentally a ______ disorder
cyclic
What factors increase the risk of major depressive disorder recurrence
> History of more than one previous depressive episode
> Co-existing: dysthymia alcohol/drug abuse, anxiety symptoms
For depression, prospective studies highlight events involving ______ and suggest _____ ______ is linked to relapse.
Loss
Expressed emotion
For bipolar disorder, attributional styles and dysfunctional attitudes interact with intervening ____ _____? Family discord predicts what kinds of outcomes?
life events
Poor short-term outcomes
According to Freud, depression is a reaction to the loss of an ______/_____ held object. Depression reflects internalized _______ impulses
unconsciously / ambivalently
aggressive
According to the behavioural model for depression, what three ways might insufficient reinforcement occur? Give an example for each
- Environment produces a loss of reinforcement (e.g. loss of job)
- Lack of requisite skills (e.g. poor social skills won’t get social reinforcement)
- Unable to enjoy or receive satisfaction from reinforcement (e.g. anxiety)
According to the Learned Helplessness model, the more ________, _______ and _______ the attributions about negative life events, the more likely depressive symptoms are to occur.
personal
stable
global
Describe the three Helplessness theories of depression.
- Learned helplessness:
Uncontrollable aversive event»_space; Sense of helplessness»_space; Depression - Attributional Reformulation
Aversive events»_space; Personal + Global + Stable factors (cognitions)»_space; Sense of helplessness»_space; Depression - Hopelessness
Aversive events»_space; Personal + Global + Stable factors (cognitions)»_space; Sense of helplessness and expectation that desirable outcomes will not occur»_space; Depression
Describe Beck’s (1979) Cognitive Triad of depression?
> Negative triad (pessimistic view of self/world/future)
Negative schema/beliefs (triggered by negative life events)
Cognitive biases
Depression
What is Beck’s Negative Triad?
Negative views about:
Oneself
The World
The Future
Describe the interpersonal theory of depression and bipolar?
People with those disorders are more likely to have social deficits - cause or effect?
The biological model of mood disorders indicates that genetics plays a role in its aetiology, what evidence supports this?
Higher freqency of mood disorders among relatives of bipolar probands than unipolar depressed probands
Most have a family history of the disorder
Classical twin studies indicate that bipolar and depression have _______ infuences
polygenic influences
According to the Catecholamine hypothesis, too much of the drug __________ may cause mania, too little may cause depression.
noradrenaline
The deficiency in serotonin may be related to depression. This hypothesis is called what?
Indolamine hypothesis
What are two limitations of neurochemical models to explain mood disorders?
- complex inter-relationships between neurotransmiters and other biological systems preclude a simple deficit model
- A simple biochemical deficit/excess model cannot account for a heterogeneous disorder like depression which involves a dysregulation of many functions
What category of antidepressants is the most commonly used for treatment?
Selective serotonin reuptake inhibitors (SSRIs)
When is electro-convulsive therapy used to treat depression?
> When there are prominent psychotic/melancholic features
Meds haven’t worked
Life-threatening situations
Prior positive reponse to ECT
What is the standard drug for treatment of manic episodes and cyclothymia?
What are other psychological therapies for bipolar disorder?
Lithium
- Group therapy
- Psychoeducation
- Family therapy
- CBT
- Interpersonal therapy
What are the two main psychological therapies for the treatment of depression? How do they compare with medication?
CBT and Interpersonal Relationship Therapy
Both as effective as each other, and as effective as medication
