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TCD > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

what are analogue experiments

A

to study something in a controlled environment
create clinical situations or sympotm manifestation in lab setting

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2
Q

fear conditioning

A

when induce a specific fear in a healthy subject - to understand physiology and techniques which help to unlearn fear

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3
Q

definition of mood

A

prolonged emotional state

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4
Q

definition of disorder

A

a gross deviation in mood from what is considered the normal range

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5
Q

which characteristics of mood disorders determine diagnosis

A

major depressive, manic, and hyponmanic episodes

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6
Q

major depressive disorder needs how many symptoms

A

5/9

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7
Q

what are the necessary features for depression diagnosis

A

present nearly everyday during same 2 week period
represents change from previous functioning
at least one symptoms is depressed mood or loss of interest/pleasure

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8
Q

symptoms of MDD

A
  • depressed mood
  • diminished interest/pleasure in almost all activities
  • weight/appetite change (weight loss/gain, increase/decrease in appetite)
  • sleep disturbance (insomnia, hypersomnia)
  • psychomotor agitation (fidgeting) or retardation (slow)
  • fatigue or loss of energy
  • feelings of worthlessness or excessive guilt
  • diminished ability to think/concentrate/indecisive
  • recurrent thoughts of death, suicidal ideation, suicide attempts/plans
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9
Q

important feature criteria for all disorders

A

must cause clinically significant distress/impairment in functioning
departure from normal state
episode is not attributable to effects of substance or other medical condition

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10
Q

clinical judgements which are not in diagnostic criteria

A

responses to significant loss may include sadness, rumination, insomnia, appetite

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11
Q

persistent depressive disorders (dysthymia) - necessary for diagnosis

A

depressed mood for most of the day, for more days than not, for at least 2 years (1 year for children and adolescents)

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12
Q

criteria for pDD

A
  • poor appetite or overeating
  • insomnia, or hypersomnia
  • low energy/fatigue
  • low self esteem
  • poor concentration or diffculty making decisions
  • feelings of hopelessness
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13
Q

how many symptoms of criteria needed for PDD

A

2 of 6

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14
Q

disruptive mood disregulation disorder

A

severe recurrent temper outbursts
persistent negative mood (anger, irritability) for at least 1 year before age 10

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15
Q

issues with diagnosis of DMDD

A

limited evidence base
poor reliability
issues with over diagnosis
only considers behavioural interventions
captures irritability but not mania

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16
Q

what was DMDD designed to reduce

A

diagnosis of bipolar disorder in children

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17
Q

premenstrual dysphoric disorder and treatment

A

mood symptoms in week before menses
hormonal treatments (SSRIs used for part of the month)

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18
Q

what is the most popular mental disorder

A

depression

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19
Q

sex differences in depression

A

females 2x more likely to get depression

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20
Q

reasons for sex differences in depression

A

stresses occur in adolescent different for sexes
female puberty more pronounced
social roles
body image
rate of reporting
victims of sexual abuse

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21
Q

age of onset of depression

A

late teens to early 20s

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22
Q

SES and depression

A

depression rates 3x higher in low SES

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23
Q

bipolar disorder description

A

distinct periods of abnormally and persistently elevated, expansive (expression of emotion, feelings of grandiosity and friendly or excuberant) or irritable mood

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24
Q

manic symptoms of bipolar disorder

A
  • increased self esteem; belief one has special powers
  • decreased need for sleep
  • unusual talkativeness
  • flight of ideas (racing thoughts)
  • distractibility
  • increase in goal directed activity / psychomotor agitation
  • excessive involvement in activities with high potential for severe consequences
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25
Q

hypomania

A

a lesser form of mania
- lasts less time, no psychosis, not significant impaired functioning

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26
Q

how many kinds of bipolar disorder

A

3

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27
Q

bipolar 1 disorder

A

at least 1 manic episode in life
often severe MDD episodes but not required for diagnosis

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28
Q

bipolar 2 disorder

A

at least one MDD episode
at least one hypomanic episode (no lifetime episode of mania)

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29
Q

cyclothymic disorder

A

for at least 2 years
- numerous period of hypomanic symptoms that do not meet criteria for hypomania
- numerous periods of depressive symptoms that do not meet criteria for MDD

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30
Q

lifetime prevalence of BP

A

~1%

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31
Q

how many cases of BP onset before 25 y/o

A

more than 50%

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32
Q

does BP have higher comorbidity and with which ones

A

~60% have 3 or more comorbidities
substance use most common in BP (40-60%)

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33
Q

subtypes and specifiers for BP

A

seasonal patterns
rapid cycling forms
psychotic features
mixed features - depression and mania at same time
catatonia
melancholic features - lack of pleasure in anything
atypical features - over/under eating
peripartum onset
anxious distress

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34
Q

aetiology ?

A

study of causes of disorders

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35
Q

BP and heritability

A

2x more heritable

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36
Q

estimate of heritability of depression

A

37%

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37
Q

how do we get estimates of heritability

A

population studied
twin studies

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38
Q

effect of stress on depression risk

A

more stress more risk

39
Q

which neurotransmitters are implicated in aetiology of mood disorders

A

dopamine
noradrenaline
serotonin

40
Q

what is the evidence for role of serotonin in disorders

A

drugs which improve disorder symptoms modulate the activity of serotonin

41
Q

which brain structures are associated with depression

A

amgdala, striatum, hippocmapus, frontal cortex, ACC

42
Q

what is the issue with brain structure aetiology

A

observations take place after incidence is identified and endured
behaviours and emotion can impact the structure and function of brain
cause and effect cannot be determined

43
Q

amygdala is responsible for?

A

emotional experience and assigning emotional relevance to stimuli

44
Q

findings about the amygdala

A

increased activity in response to negative stimuli
abnormalities in responsibility of amygdala found in those with familial risk for depression

45
Q

what is the striatum for

A

rewward processing and motivation

46
Q

findings about striatum

A

reduced activity in ventral striatum may be linked to learning from reward and issues with motivation
increased striatum activity in BP - play role in impulsive behaviours

47
Q

what happens with HPA axis in prolonged stress states

A

increased blood pressure
chronic msucle tensions
neurotoxicity and neural atrophy
disturbances in neurotransmitters

48
Q

increased high cortisol levels risk?

A

MDD

49
Q

cortisol responses in MDD and BP

A

consistent dysregulation in HPA axis

50
Q

what does increased amygdala reactivity do

A

triggers HPA axis

51
Q

why is stress good for the hippocampus

A

improves functionality

52
Q

what happens when hippocampus is overactivated with stress

A

goes into poor functioning and loss of neurons

53
Q

MDD patients and hippocampus

A

MDD have smaller hippocampal volumes

54
Q

cognitive theories and assumption made? of aetiology

A

bad things happen, but what is important is how we think about them

55
Q

what is the negative triad

A

person has negative view of self
negative view of future
negative view of world

56
Q

what happens when we have negative schemas

A

influences how we evaluate information

57
Q

when are schemas activated

A

when someone encounters as situation similar to the ones which caused the schema to form

58
Q

when are schemas acquired

A

in childhood and exacerbated by childhood experiences

59
Q

what is beck’s theory of schemas

A

schemas activated by events which influence information processing - cognitive bias
- MDD patients attend to negative informaiton more than positve, schema of world is confirmed and maintained

60
Q

negative cognitive styles and MDD

A

negative cognitive styles elevate risk of developing MDD

61
Q

what is hopelessness theory

A

idea that good things wont happen and we cannot change this

62
Q

hopelessness theory and attribution

A

when something bad happens, we attribute a cause
what we determine as cause is considered correct

63
Q

hopelessness theory and therapy

A

to adjust cognitive styles around attributions

64
Q

hopelessness and MDD

A

high levels of hopelessness 6x more likely to experience MDD episodes in future

65
Q

major risk factor for mood disorders

A

childhood adversity

66
Q

stress diathesis model

A

experience of seriosu life event before MDD begins

67
Q

effect of stressful events

A

reduce resilience, problems more likely to occur

68
Q

what is the first line of medication for MDD

A

antidepressants

69
Q

SSRIs are

A

most prescribed
increase level of serotonin available
blocks reuptake

70
Q

results of antidepressants

A

37% achieve remission with first antidepressant
around 50% reduction in disorder
30% of people respond to placebo

71
Q

medications for BP

A

mood stabilisers
lithium
antipsychotic medications
anticonvulsant
antidepressants

72
Q

mood stabilsiers

A

medications for BP reducing manic symptoms

73
Q

lithium

A

first line treatment for BP, 80% of BP cases experience mild benefits
lowers excess noradrenaline in manic episodes and triggers serotonin in depressive episodes

74
Q

antipsychotic medication

A

given during manic episodes

75
Q

anticonvulsant medication

A

given for rapid cycling in BP

76
Q

antidepressants for BP

A

given during depressive episodes

77
Q

issues with lithium as BP medication

A

must be closely monitored as high levels can be toxic
affects many bodily functions (weight gain, increased thirst, tremors, circulatory problems)

78
Q

antidepressants in BP patients without lithium

A

can initiate manic episode

79
Q

what is ECT

A

Electroconvulsive therapy
v effective in treating severe depression

80
Q

why is ECT controversial

A

used to be done without consent
long side effects of memory loss, impairments in cognitive function

81
Q

why is ECT used and response rate

A

effective for treatment resistant depression
- reduces the suicide risk associated with severe depression
70% response rate

82
Q

psycho-education

A

helping to understand the symptoms, nature and course of disorders etc

83
Q

what is CBT

A

combo of cog and behavioural approaches

84
Q

key components of CBT

A
  • thoughts, feelings and behaviours are all interconnected and trap individuals in a cycle
  • reevaluates negative views or interpretations
  • breaks cycle, challenges cognitive beliefs and schemas, feelings of negativity
  • develop strategies to think about and deal with problem in more positive way
85
Q

psychodynamic therapy

A

focuses on thought pattern existing today rather than from the past

86
Q

what influences how people view world in a biassed way, and how to overcome

A

negative automatic thoughts
- understand link between thoughts and emotions, estimate evidence for and against NAT, challenge NAT, and generate more balanced alternative thoughts

87
Q

combination of psych therapy and medication for MDD?

A

best approach
improves odd of recovery by 10-20%

88
Q

why are antidepressants good

A

offer relief from symptoms quicker

89
Q

why is therapy good

A

takes longer but imparts skills they can use after treatment is over - preventative

90
Q

psychotherapy treatments of BP - methods

A

concurrent psychosocial and psychotherapy address associated social and psychological problems

91
Q

psychotherapy for BP - what does it do

A

improves ability to detect mania
encourages acceptance of illness
improves adherence to drug regimen
enhance ability to cope with stressors
fosters daily routines of sleep
improves communications with family
eliminates drug or alcohol misuse

92
Q

treatment for disruptive mood dysregulation disorder and what does it do

A

CBT for anger and disruptive behaviour - relabels perceptions that lead to outbursts, tolerate frustration, coping skills
dialectical behaviour therapy -skills to regulate emotions, targets irritability

93
Q

medications for disruptive mood dysregulation disorder

A

antidepressants for irritability and mood
stimulations for irritability
atypical antipsychotic medications for aggression)

TCD (17 decks)

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