Mood Disorders Flashcards
what is unipolar depression?
major depressive disorder
- average age of onset: 30
features of unipolar depression (need to have two for two or more weeks)?
‣ Depressed mood
‣ Loss of interest in activities
‣ Appetite and sleep problems
‣ Loss of energy
‣ Difficulty thinking/concentrating
‣ Psychomotor slowing/agitation
‣ Feelings of worthlessness/inappropriate guilt
‣ Thoughts of death or suicide
‣ In children/adolescents, see more irritableness, anger outbursts
epidemology (unipolar depression)?
twice as common in women
suicide?
- 10-15% of diagnosed complete suicide
- highest level in 30 years
- white males = 7/10 suicides
- “deaths of despair” : sharp increase in suicide for non college educated middle aged white people (mountain states have highest rates)
golden gate bridge studies show?
Suicidal intent remains uncertain up to the very last second
what is ambivalence (unipolar depression)?
the interaction of risk and protective factors that changes literally moment by moment (the norm)
treatment (unipolar depression)?
a. antidepressant medications
- Traditional: Tricyclics, MAOI’s
- Newer: SSRI’s, SNRI’s, combinations (black box warning)
b. Psychotherapy (especially cognitive behavioral)
c. Electroconvulsive therapy (ECT)
d. Brain Stimulation Treatments
e. Ketamine infusions, Psilocybin—very new, still being studied but shows promise
features of bipolar disorder?
‣ Euphoria
‣ Inflated self-esteem
‣ Sleeplessness
‣ Distractibility
‣ Agitated, irritable, “touchy”
‣ Racing thoughts, fast speech
‣ Reckless behavior
‣ Usually also depressive episodes
epidemiology (bipolar disorder)?
- 80% of all cases classified as “severe”
‣ Average age of onset 18
‣ No gender differences
‣ Tends to be a chronic course
‣ Estimated that 10-18% of those diagnosed with bipolar complete suicide (accounts for about 25% of all suicides)
treatment of bipolar disorder?
- Mood stabilizers: e.g., lithium, valproic acid, aripiprazole (Abilify)
‣ Antidepressant medications (must be carefully monitored because can sometimes trigger a manic episode) - Psychotherapy and supportive therapy
adoption/twin studies of unipolar depression?
- Six different twin studies show average concordances of 43% for MZ, and 28% for DZ
- Largest twin study to date (Sweden) yielded heritability estimates of .38, with no shared environmental influence
- More severe depression shows higher heritability, about .58
adoption/twin studies of bipolar disorder?
‣ Average concordances MZ approach 80%, 15% DZ
‣ Small study of twins reared apart showed concordances of 72% for MZ, 24% DZ
‣ Approximate genetic risk as estimated from pooled twin studies = 55% (MZ) vs 7% (DZ)
environmental risk factors of BPD and UD?
‣ Being divorced or separated (two fold increase compared to those married and those never married)
‣ Adverse life events (especially interpersonal loss)
‣ Early life trauma, abuse, neglect (particularly sexual abuse)
chronic HPA activation = _____?
epigenetic effect
possible genes?
- 5 HTT (serotonin) transporter gene
- HTPH2 mutation (another serotonin-related gene)
- Almost certainly, many more genes for both disorders are involved!
