Mood Disorders Flashcards
Group of disorders describing the range of depression to mania
Mood disorders
List the DSM-5 TR’s criteria (A-E) for major depressive disorder
Criterion A: significant depressive symptoms
Criterion B: significant distress or impairment in social, occupational, or other important areas of functioning
Criterion C: The episode is not caused by the physiological effects of a substance or medical condition
Criterion D: Not better explained by another disorder
Criterion E: There has never been a manic or hypomanic episode
For criterion A of the DSM-5 TR’s diagnostic criteria for major depressive disorder, which/how many symptoms need to be present in order for a diagnosis to be made?
Five (or more) of the symptoms have been present during the same 2-week period and represent a change from previous functioning
At least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure (anhedonia)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
Anhedonia
What are the 9 symptoms of major depressive disorder as identified by criterion A of the DSM-5 TR for this disorder?
Depressed mood most of the day, nearly every day,
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (anhedonia)
Significant weight loss when not dieting or weight gain
Insomnia (limited sleeping) or hypersomnia (oversleeping) nearly every day.
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
Diminished ability to think or concentrate, or indecisiveness, nearly every day
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
What can produce symptoms similar to MDD and as such must be considered when making a diagnosis?
Significant loss/grief
What are two major specifiers with respect to MDD?
Severity (mild, moderate, severe) and single episode vs recurrent
Compare mild, moderate, and severe MDD.
Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, the intensity of the symptoms is distressing but manageable, and the symptoms result in minor impairment in social or occupational functioning.
Moderate: The number of symptoms, intensity of symptoms, and/or functional impairment are between those specified for “mild” and “severe.”
Severe: The number of symptoms is substantially in excess of that required to make the diagnosis, the intensity of the symptoms is seriously distressing and unmanageable, and the symptoms markedly interfere with social and occupational functioning.
Which factors contribute to someone experiencing recurrent MDD?
Individuals with recurrent major depression usually have a family history of depression, unlike people who experience single episodes
Up to 85% of single-episode cases later experience a second episode
Name and describe three notable “other” MDD specifiers
With seasonal pattern (commonly known as Seasonal Affective Disorder)
With peripartum onset: before or after giving birth
With psychotic features: negative beliefs can become extreme and delusional
List the diagnostic criteria (A-G) for persistent depressive disorder as outlined by the DSM-5 TR.
A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.
B. Presence, while depressed, of two (or more) of the listed symptoms
C. Criteria for major depressive disorder may be continuously present for 2 years.
E-G: no manic symptoms; better explained by another disorder; not explained by medical condition or substances; distress and dysfunction
List the six symptoms of PDD under criterion B of the diagnostic criteria outlined in the DSM-5 TR.
Poor appetite or overeating.
Insomnia or hypersomnia.
Low energy or fatigue.
Low self-esteem.
Poor concentration or difficulty making decisions.
Feelings of hopelessness.
Meeting diagnostic criteria for Major Depressive Disorder AND Persistent Depressive Disorder (happens in about 1/5 of PDD patients)
Double depression
List three reasons as to why the prognosis for PDD is often worse than MDD
Higher rates of comorbidity with other mental disorders
Are less responsive to treatment
Show a slower rate of improvement over time
Appropriate sadness that re-emerges around key dates, triggers, in addition to ability to remember positives and accept the finality of the loss
Integrated grief
Debilitating grief that lasts longer than culturally expected and interferes with functioning
Complicated grief
Not a formal mood disorder, newly added to the DSM-5 under Trauma and Related disorders
Prolonged grief disorder
Approximately what percent of the global population will experience MDD at some point in their life?
16%
What gender differences exist concerning the prevalence of mood disorders?
Women are about twice as likely to have mood disorders as men; Men are more likely to commit suicide
What is the average age of onset of depression?
25 (Risk increases dramatically during adolescence)
What is the average duration of the first episode of untreated MDD?
Two to nine months
What is the median duration of an episode of PDD?
Approximately five years in adult (can last as long as 30 years)
Name three biological factors that could contribute to the onset of depression
Genes (e.g. serotonin transporter)
Sleep and circadian rhythms
Hormonal system (e.g. hypothyroidism)
List five psychosocial factors that could contribute to the onset of depression
Life stressors (e.g., poverty)
Developmental: transitions to new stages of life
Relationship issues (e.g., divorce, bullying, abuse)
Negative cognitive styles
Social isolation: the risk of depression for people who live alone is almost 80% higher than for people who live with others
Describe the stepped-care approach to treating depression
Triaging system: How much support does this person need?
Steps:
1. All known and suspected presentations of depression
2. Persistent subthreshold depressive symptoms (mild to moderate)
3. Persistent subthreshold depressive symptoms or mild to moderate depression with inadequate response to initial interventions (moderate and severe)
4. Severe and complex depression; risk to life; severe self-neglect
What are the three key techniques used in cognitive behavioural therapy?
Behavioural activation: Action before motivation
Cognitive restructuring: Challenging negative thinking patterns
Behavioural experiments: Testing negative beliefs
Anything that provides a sense of joy (e.g. seeing friends, going to the movies) (CBT)
Pleasure activities