Module 14: Depressive Disorders Flashcards
Types of Unipolar Disorders
- Unipolar Disorders Disruptive Mood Dysregulation Disorder
- Major Depressive Disorder
- Persistent Depressive Disorder (Dysthymia)
- Premenstrual Dysphoric Disorder
- Seasonal Affective Disorder
- Integrated Grief
- Complicated Grief
Disruptive Mood Dysregulation Disorder
+ 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
How often should the symptoms of Disruptive Mood Dysregulation Disorder be before it can be diagnosed?
+ 3 or more times/week, ≥ 12 months
+ 12 or more months, at least 2 settings
What is the onset of Disruptive Mood Dysregulation Disorder?
onset should be after 6 yrs-18yrs
What is Disruptive Mood Dysregulation Disorder associated with?
factors associated with disrupted family life
What may be a strong risk factor for Disruptive Mood Dysregulation Disorder?
family history of depression may be a risk factor
When should Disruptive Mood Dysregulation Disorder not be diagnosed?
do not occur exclusively during MDE
What is the difference between Disruptive Mood Dysregulation Disorder and bipolar disorder?
bipolar = episodic, DMDD = persistent
When should a diagnosis of DMDD NOT be made when it comes to children?
+ 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
When should a diagnosis of DMDD be made in children?
if children have symptoms that meet criteria for ODD or IED and DMDD, then only DMDD is the diagnosis
Major Depressive Disorder
at least 2 weeks of either anhedonia or depressed mood
What is MDD associated with?
associated with high mortality
What is the biological explanation of MDD?
hyperactivity in HPA axis and it appears to be associated with melancholia, psychotic features, and risks for eventual suicide
When can a specifier of “other specified depressive disorder” be added to a diagnosis of psychotic disorder?
“other specified depressive disorder” can be made in addition to the diagnosis of psychotic disorder, if the depressive symptoms meet full criteria for MDE
How many weeks should schizoaffective, delusions, or hallucinations not co-occur with MDE?
in schizoaffective, delusions or hallucinations occur exclusively for 2 weeks without MDE
What are the types of MDD?
Seasonal, Catatonic, Melancholic
What disorders are comorbid with MDD?
other disorders with which MDD co-occurs are substance-related disorders, panic disorder, GAD, PTSD, OCD, AN, BN, and Borderline PD
Persistent Depressive Disorder (Dysthymia)
depressed mood for at least 2 years
What diagnosis should be made if criteria for MDE has been made during PDD?
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
When is a diagnosis of PDD NOT made?
a separate diagnosis of PDD is not made if the symptom occur only during the course of the psychotic disorder
Double Depression
suffer from both MDE and PDD with fewer symptoms
Premenstrual Dysphoric Disorder
+ 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
Seasonal Affective Disorder
+ episodes must have occurred for at least 2 yrs with no evidence of nonseasonal MDE during that period of time
+ Cabin fever
Integrated Grief
acute grief, the finality of death and its consequences are acknowledged and the individual adjusts to the loss
Complicated Grief
this reaction can develop without preexisting depressed state
What is a more severe variant of mood disorders: unipolar or bipolar?
Bipolar disorder may simply be a more severe variant of mood disorders
What were the world’s first documented mental illnesses?
Depression and mania appear to be the world’s first documented mental illnesses
Aretaeus of Cappadocia
combined these two groups of symptoms into bipolar disorder by stating that mania was a worsened state of melancholia
Theophile Bonet
began using the term melancholicus mania in 1679
Willis
described Melancholia and Mania as distempers of raving in his writing
Emil Kraeplin
employed a unifying approach to the classification of mood disorders, resulting in bipolar disorder being subsumed within the category of manic-depressive insanity (MDI)
Manic-Depressive Insanity
Individuals with this diagnosis experienced mild residual states after recovery from individual episodes and mild fluctuations between episodes
Who were some of the first to make references to manic-depressive symptoms in children?
Adolf Meyer, Karl Abraham, and Melanie Klein, were some of the first to make references to manic-depressive symptoms in children
What are the things to consider in the Dx of Depressive Disorder DUE to another med condition?
✓ 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
