mood disorders Flashcards
what are some general characteristics for depressive disorders
- Low mood along time (sadness, emptiness) (irritability in children)
- Recurrent thoughts of undervaluation, insecurity, guilt, hopelessness or death
- Generalized loss of interest
- Fatigue, tiredness, loss of energy
- Changes in sleep and/or weight
- loss of interest, guilt
- atypical (eating a lot)
- psychotic
what are some subtypes for depressive disorders
- major depression disorder: single episode, recurrent episode (85%)
- dysthymia or persistent depressive disorder: mild intensity, long duration >2 years
describe postpartum
- 10 % (5-25%)
Factors: - Biological changes (hormones, etc.)
- Previous Emotional Instability
- Intolerance of mixed emotions or of disability
- Lack of social support
what is depression according to Freud
Inverted hostility against the self because a need of suffering
what is depression according to james coyne
loss of social relationships
what is depression according to Aaron Beck
the persistent negative cognitions cause depression and they are also consequenses from it
describe the Cognitive Behavioral Approach
“Negative Cognitions”
Form
- Inaccurate
- Sustained
- Often intrusive
Content:
* about the self, the world, the future (depressive cognitive triad)
how to evaluate depressive disorder
- evaluation of suicidal ideation
- evaluation of drug-treatment need
- questionnaires:
BDI: beck depression inventory
HDRS: hamilton depression rating scale
CES-D: center for epidemiologic studies depression scale
CDI: children’s depression inventory
SSI: scale for sucide ideation
How much cronbach’s alpha is there for BDI-II (depressive disorder)
0.91
what interventions is there for depressive disorder
- CBT
- interpersonal therapy
- pharmacotherapy (effective in severe depressive disorders
what are CBT key objectives in depressive disorder
- challenging and neutralizing negative thoughts and false beliefs using socratic dialoge
- examining evidence for sustain thoughts
why is meditation effective in depressive disorders
helps to stop elaborative thinking
describe interpersonal psychotherapy
- typical duration: 12-16 weeks
focus on:
- interpersonal distress (role conflict, relationship difficulties)
- loss
- life span relationships
what are the objectives for interpersonal therapy (depressive disorder)
- Enhancing social support
- Decreasing interpersonal stress
- Facilitating emotional processing
- Improving interpersonal skills
what pharmacotherapy is there for depressive disorder and what are the problems
- antidepressants
- side effects
- efficacy is not immediate
- don’t maintain effects
what happens in the brain (depressive disorder)
lower: serotonine, dopamine
hippocampus: 10-20% volume reduction
what are the four main groups of antidepressants
- Monoamine Oxidase Inhibitors (MAOIs)
- Tricyclic antidepressants
- Atypical antidepressants
- Selective Serotonin Reuptake
Inhibitors (SSRI) (FIRST OPTION now)
what other therapies is there for depressive disorder
- Electroconvulsive Therapy
- Transcraneal stimulation
what are some manic symtoms of bipolar disorders
(at least 1 week)
* Euphoria
* Loquacity- Bekvämlighet
* Reduced need for sleep
* Increase of sexual impulse
* Distraction
* Irritability
* Delusions
what are some subtypes of bipolar disorder
Bipolar I Disorder:
- Manic episodes
Bipolar II Disorder:
- Hypomanic episodes
Cyclothymic Disorder:
- Fast changes between up and lows
- Mild intensity symptoms
- Duration > 2 years (1 year in children and adolescents)
what is the diagnostic criteria for manic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
B. During the period of mood disturbance and increased energy or activity, **three (or more) of the following symptoms (four if the mood is only irritable) are present **to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as
reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences (e.g.,
engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another medical condition.
describe Hypomanic episode
- Less duration (but at least 4 days)
- Less intensity than a manic episode
- No hospitalization is necessary
diagnostic criteria for hypomanic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and
persistently increased goal-directed activity or energy, lasting at least 4 days and present most of the day, nearly
every day.
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (fourif the mood is only irritable) are present to a significant degree and represent a noticeable change from usual
behavior:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or
observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in
unrestrained buying sprees, sexual indiscretions, or foolish business investments).
C. The episode is associated with an unequivocal change in functioning that is uncharacteristics of the individual when not
symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate
hospitalization. If there are pychotic features, the episode is, by definition, manic.
F. Not attributable to a substance
what is the warning for drugs in bipolar disorders
Many drugs may provoke manic or hypomanic episodes
what are some difficulties in diagnosis (bipolar disorder)
- Most people do not know this disorder
- When a person is suffering an hypomanic episode, no disease awareness is present in most cases
- Sometimes there is a confusion when person is taking drugs
- It is difficult to be distinguished from happiness
what is Cyclothymic Disorder
- At least 2 months of hypomanic symptoms but not hypomanic episodes
- At least 2 months of depressive symptoms but not depressive disorders
- During at least 2 years
how many % of bipolar disorder is there
1%
- high risk of suicide
- divorce in 60% of cases after diagnosis
describe distress in bipolar disorder
job, family, grief
how do you evaluate bipolar disorder
YMRS- young mania rating scale
P-YMRS- parents-young mania rating scales
what interventions is there for bipolar disorder
pharmacotherapy
- mood stabilizers
- atypical antipsychotics
psychotherapy
Because bipolar disorders are:
– recurrent
– with great personal and interpersonal impact
– sometimes dangerous for life
Helping in maintain medication (if prescribed)
* Restauring psychological functioning
* Preventing relapse by
–Information
–Implementation of regular life and safety behaviors
