Module 14: Depressive Disorders

Question 1

Types of Unipolar Disorders

Answer 1

1. Unipolar Disorders Disruptive Mood Dysregulation Disorder
2. Major Depressive Disorder
3. Persistent Depressive Disorder (Dysthymia)
4. Premenstrual Dysphoric Disorder
5. Seasonal Affective Disorder
6. Integrated Grief
7. Complicated Grief

Question 2

Disruptive Mood Dysregulation Disorder

Answer 2

+ recurrent temper outburst (verbally or behaviorally) that are grossly out of proportion
+ irritable or angry most of the day
+ presence of severe and frequently recurrent outburst and persistent disruption in mood between outburst
+ severe in at least one setting and mild to moderate to second setting

Question 3

How often should the symptoms of Disruptive Mood Dysregulation Disorder be before it can be diagnosed?

Answer 3

+ 3 or more times/week, ≥ 12 months
+ 12 or more months, at least 2 settings

Question 4

What is the onset of Disruptive Mood Dysregulation Disorder?

Answer 4

onset should be after 6 yrs-18yrs

Question 5

What is Disruptive Mood Dysregulation Disorder associated with?

Answer 5

factors associated with disrupted family life

Question 6

What may be a strong risk factor for Disruptive Mood Dysregulation Disorder?

Answer 6

family history of depression may be a risk factor

Question 7

When should Disruptive Mood Dysregulation Disorder not be diagnosed?

Answer 7

do not occur exclusively during MDE

Question 8

What is the difference between Disruptive Mood Dysregulation Disorder and bipolar disorder?

Answer 8

bipolar = episodic, DMDD = persistent

Question 9

When should a diagnosis of DMDD NOT be made when it comes to children?

Answer 9

+ diagnosis cannot be assigned to a child who has ever experienced full-duration hypomanic or manic episode (irritable or euphoric) or who has ever had a manic or hypomanic episode lasting more than 1 day
+ children with DMDD should not have symptoms that meet criteria for BD, as in that context, only the bipolar disorder diagnosis should be made

Question 10

When should a diagnosis of DMDD be made in children?

Answer 10

if children have symptoms that meet criteria for ODD or IED and DMDD, then only DMDD is the diagnosis

Question 11

Major Depressive Disorder

Answer 11

at least 2 weeks of either anhedonia or depressed mood

Question 12

What is MDD associated with?

Answer 12

associated with high mortality

Question 13

What is the biological explanation of MDD?

Answer 13

hyperactivity in HPA axis and it appears to be associated with melancholia, psychotic features, and risks for eventual suicide

Question 14

When can a specifier of “other specified depressive disorder” be added to a diagnosis of psychotic disorder?

Answer 14

“other specified depressive disorder” can be made in addition to the diagnosis of psychotic disorder, if the depressive symptoms meet full criteria for MDE

Question 15

How many weeks should schizoaffective, delusions, or hallucinations not co-occur with MDE?

Answer 15

in schizoaffective, delusions or hallucinations occur exclusively for 2 weeks without MDE

Question 16

What are the types of MDD?

Answer 16

Seasonal, Catatonic, Melancholic

Question 17

What disorders are comorbid with MDD?

Answer 17

other disorders with which MDD co-occurs are substance-related disorders, panic disorder, GAD, PTSD, OCD, AN, BN, and Borderline PD

Question 18

Persistent Depressive Disorder (Dysthymia)

Answer 18

depressed mood for at least 2 years

Question 19

What diagnosis should be made if criteria for MDE has been made during PDD?

Answer 19

if full criteria for a MDE has been met at some point during the period of illness, a diagnosis of MDD would apply. Otherwise, a diagnosis of “other specified depressive disorder” or “unspecified depressive disorder” should be given

Question 20

When is a diagnosis of PDD NOT made?

Answer 20

a separate diagnosis of PDD is not made if the symptom occur only during the course of the psychotic disorder

Question 21

Double Depression

Answer 21

suffer from both MDE and PDD with fewer symptoms

Question 22

Premenstrual Dysphoric Disorder

Answer 22

+ majority of menstrual cycles, at least 5 symptoms must be present
+ delusions and hallucinations have been described in the late luteal phase of the menstrual cycle but are rare

Question 23

Seasonal Affective Disorder

Answer 23

+ episodes must have occurred for at least 2 yrs with no evidence of nonseasonal MDE during that period of time
+ Cabin fever

Question 24

Integrated Grief

Answer 24

acute grief, the finality of death and its consequences are acknowledged and the individual adjusts to the loss

Question 25

Complicated Grief

Answer 25

this reaction can develop without preexisting depressed state

Question 26

What is a more severe variant of mood disorders: unipolar or bipolar?

Answer 26

Bipolar disorder may simply be a more severe variant of mood disorders

Question 27

What were the world’s first documented mental illnesses?

Answer 27

Depression and mania appear to be the world’s first documented mental illnesses

Question 28

Aretaeus of Cappadocia

Answer 28

combined these two groups of symptoms into bipolar disorder by stating that mania was a worsened state of melancholia

Question 29

Theophile Bonet

Answer 29

began using the term melancholicus mania in 1679

Question 30

Willis

Answer 30

described Melancholia and Mania as distempers of raving in his writing

Question 31

Emil Kraeplin

Answer 31

employed a unifying approach to the classification of mood disorders, resulting in bipolar disorder being subsumed within the category of manic-depressive insanity (MDI)

Question 32

Manic-Depressive Insanity

Answer 32

Individuals with this diagnosis experienced mild residual states after recovery from individual episodes and mild fluctuations between episodes

Question 33

Who were some of the first to make references to manic-depressive symptoms in children?

Answer 33

Adolf Meyer, Karl Abraham, and Melanie Klein, were some of the first to make references to manic-depressive symptoms in children

Question 34

What are the things to consider in the Dx of Depressive Disorder DUE to another med condition?

Answer 34

✓ No depressive prior to the onset of medical condition (e.g., before Manny was diagnosed with cancer, he never experienced depressive episodes)
✓ the probability that a medical condition has a potential to cause a depressive disorder