Mood/Depressive Disorders Flashcards
What are the 4 unipolar depressive disorders?
Major depressive disorder
Persistent depressive disorder
Premenstrual dysphoric disorder
Disruptive mood dysregulation disorder
What is the lifetime prevalence of MDD?
15%
What is the common age of onset for depession?
Early 20s
2 examples of co-morbidity of MDD
- 5-30% with MDD experience PDD
2. 60% of those with MDD will also meet criteria for anxiety disorder at some point
DSM-5 Criteria for MDD
- Sad mood OR loss of interest and pleasure
- Plus 4 other symptoms:
-Sleeping too much or too little
-Psychomotor retardation or agitation
-Poor appetite and weight loss, or increased
appetite and weight gain
-Loss of energy
-Feelings of worthlessness or excessive guilt
-Difficulty concentrating, thinking, or making decisions
-Recurrent thoughts of death or suicide - Symptoms are present:
-Nearly every day
-Most of the day
-For at least 2 weeks - Symptoms are distinct and more severe than a normative response to significant loss
DSM-5 Criteria for PDD
1. Depressed mood for at least 2 years (1 year for children/adolescents) 2. Plus 2 other symptoms: -Poor appetite or overeating -Sleeping too much or too little -Low energy -Poor self-esteem -Trouble concentrating or making decisions -Feelings of hopelessness 3. Symptoms do not clear for more than 2 months at a time 4. Bipolar disorders are not present
What is mania?
State of intense elation, irritability, or activation
What is hypomania?
hypo = “under”
Symptoms of mania (intense elation, irritability, or activation) but less intense
-Does not involve significant impairment
DSM-5 criteria for manic and hypomanic
episodes
- Distinctly elevated or irritable mood
- Abnormally increased activity and energy
- Plus 3 other symptoms (four if mood is irritable):
-Increased goal-directed activity or psychomotor agitation
-Talkativeness or rapid speech
-Flight of ideas or racing thoughts
-Decreased need for sleep
-Increased self-esteem or grandiosity
-Distractibility
-Excessive involvement in activities that are likely to have undesirable consequences - Symptoms are present most of the day, nearly
every day - For a manic episode:
-Symptoms last at least 1 week, require hospitalization, or include psychosis
-Symptoms cause significant distress or functional impairment - For a hypomanic episode:
-Symptoms last at least 4 days
-Clear changes in functioning that are observable to others, but impairment is not marked
-No psychotic symptoms are present
DSM-5 criteria for bipolar I
At least one episode of mania
DSM-5 criteria for bipolar II
- At least one major depressive episode
- At least one episode of hypomania
- No episodes of mania
DSM-5 criteria for cyclothymic disorder (cyclothymia)
(Milder, chronic form of bipolar disorder)
1. Symptoms lasts at least 2 years in adults
(1 year in children/adolescents)
2. Numerous periods with hypomanic and depressive symptoms
3. Does not meet criteria for hypomania or major depressive episode
4. Symptoms do not clear for more than 2 months at a time
5. Symptoms cause significant distress or impairment
What are the prevalence rates for bipolar disorders?
- 1% in U S; 0.6% worldwide for Bipolar I
- 0.4% – 2% for Bipolar II
- 4% for Cyclothymia
What are the 3 bipolar depressive disorders?
- Bipolar I
- Bipolar II
- Cyclothymia
What is the average age of onset for bipolar disorders?
20s
Are there gender differences in rates of bipolar disorders?
- No gender differences
- Women experience more depressive episodes
Are there gender differences in rates of unipolar disorders?
Twice as common in women than in men
Factors contributing to the onset of mood disorders
- Genetic factors
- Neurotransmitters
- Brain function
- Neuroendocrine System
- Social factors
- Psychological factors
What are the heritability estimates of MDD?
37%
What are the heritability estimates of bipolar disorder?
93%
Which NTs are (likely) related to mood disorders?
- Norepinephrine
- Dopamine
- Serotonin
What 3 brain regions are related to mood disorders and how?
elevated/decresed activity and the main relevant function of the region
- Oversensitivity to emotional stimuli (elevated activity in the amygdala)
- Interference with emotion regulation (elevated activity in anterior cingulate, diminished in prefrontal cortex and hippocampus)
- Motivation to pursue rewards (striatum)
- Disruptions in the connectivity of these regions