Mood Disorders Flashcards

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1
Q

Major depressive episode (MDE)

A

2 week period marked by depressed mood every day, loss of interest or pleasure, physical/behavioral symptoms, and cognitive symptoms
Either depressed mood or loss of pleasure must be present

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2
Q

Anhedonia

A

Loss of interest or pleasure

No longer finding enjoyment in favorite activities

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3
Q

Physical/behavioral symptoms of MDE

A

Weight loss/gain or disturbed appetite
Insomnia or hypersomnia
Psychomotor agitation or retardation (slowing down of psychological and motor functioning)
Fatigue/loss of energy

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4
Q

Cognitive symptoms of MDE

A

Feelings of worthlessness or excessive guilt
Concentration difficulties
Hopelessness
Recurrent thoughts of death or suicide

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5
Q

Manic episode

A
1 week period (shorter if hospitalized) marked by 3 of following:
Inflated self-esteem or grandiosity
Decreased need for sleep
Talkativeness
Flight of ideas
Distractibility
Increased goal directed behavior (not increase in productivity- can't focus on details)
Reckless, risk taking behavior
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6
Q

Hypomanic episode

A

4 day period marked by elevated, expansive, or irritable mood and increased goal-directed behavior (same symptoms as manic episode, but less severe)
No impairment present

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7
Q

Major depressive disorder (MDD) description

A

1 or more MDE
No manic episodes or hypomanic episodes
Usually recurrent episodes, but can exist with only 1 episode

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8
Q

Bipolar I disorder

A

1 or more manic episode

MDE and hypomanic episode not required

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9
Q

Bipolar II disorder

A

1 or more MDE and hypomanic episode
No manic episode
Fluctuation from high to low
Not so high that it’s impairing

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10
Q

MDD epidemiology

A

17% lifetime prevalence (one of most common disorders)
2:1 female to male
Age of onset: usually 20’s, but can occur in retirement age
Course: episodic (average episode 4-9 months and 80-90% experience subsequent episodes)

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11
Q

Problem with treating MDD

A

Because disorder is episodic, it’s hard to tell if treatment caused end of episode or if episode just ended on its own

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12
Q

MDD specifiers

A
Psychotic features (delusions and hallucinations)
Peripartum onset (after childbirth)
Seasonal pattern (winter: lack of sunshine)
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13
Q

Delusion

A

Thoughts with no basis in reality

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14
Q

Hallucination

A

Sensory experience without stimuli

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15
Q

MDD biological causes/contributors

A

Genetic vulnerability (~50%)
Low levels of serotonin in relation to other neurotransmitters
HPA
Increased REM sleep (contributor; don’t know why this happens)
Higher activity on right side of brain than left
Highly comorbid with other disorders, especially anxiety disorders

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16
Q

Life stressors that can lead to MDD

A

Marital distress
Life changes/stresses: school, death, losing job, holidays, etc.
Lack of social support

17
Q

MDD psychological causes/contributors

A
Learned helplessness ("I don't have any way to get out of this, so why even try?")
Lack of reinforcement from environment (putting forth an effort doesn't change anything)
Maladaptive beliefs ("I am worthless" or "I am unlovable")
Cognitive triad (negative beliefs about self, present, and future)
18
Q

Medications used to treat MDD

A

Tricyclic antidepressants
Monoamine oxidase inhibitors (MAOIs): inhibit MAO that breaks down serotonin; seldomly used due to drug interactions
SSRIs and SNRIs

19
Q

Last ditch effort treatments of MDD

A
Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation
20
Q

Electroconvulsive therapy (ECT)

A

Last resort in treating MDD, but highly effective (treats ~70% of untreatable cases)
How it treats depression is unknown
Side effects: short-term memory loss; sometimes nausea, dizziness, or headaches

21
Q

Transcranial magnetic stimulation

A

Last ditch effort treatment of MDD

Magnet directs pulse to brain, stimulating it

22
Q

Therapeutic techniques used to treat MDD

A
Behavioral activation: get people out doing fun things
Cognitive restructuring: attack defeatist thoughts
Interpersonal therapy (IPT): focus on relationships/loss and building new relationships
23
Q

Combining medicine and therapy in treating MDD

A

Similar success rates of therapy and meds

Combining treatment is beneficial: decreased recurrence of depressive episodes

24
Q

Persistant depressive disorder (dysthymia)

A

Depressed mood lasting at least 2 years (no 2 month period without symptoms)
Similar symptoms to MDD: poor appetite, poor sleep, low energy, low self-esteem, poor concentration, feelings of hopelessness
Long-term low level depression

25
Q

Bipolar disorders epidemiology

A
Very small lifetime prevalence: 0.4-1.6%
Age of onset: early adulthood (18-22)
Equal occurrence in males and females
Course: episodic
Bipolar II can develop into bipolar I
Average 4 episodes occur in 10 years (not daily fluctuations in mood)
26
Q

Bipolar disorders as severe mental illnesses

A

Chronic
Unpredictable
Severe impact to individual (in manic state, can behave recklessly and doesn’t seek help)

27
Q

Bipolar disorders specifiers

A

Psychotic features

Rapid cycling: more frequent episodes

28
Q

Bipolar disorders causes and contributors

A

Vastly unknown
~50% genetic influence
Excess dopamine in manic state (reward system: feeling invincible)

29
Q

Medications used to treat bipolar disorders

A

Lithium salts: mood stabilizer; don’t know why they work
Anticonvulsants: used more often than lithium- slightly less increase in suicidality
Medication compliance poor (don’t want to take something that will bring person down from manic state)
Medicating depression can induce manic episode

30
Q

Therapeutic treatments of bipolar disorders

A

CBT treats depression, but not mania

Hospitalization is often necessary: protect person from own risky behavior

31
Q

Cyclothymia

A

2 years of numerous periods of hypomanic symptoms and depressive symptoms
No MDE, manic episode, or hypomanic episode
No 2 month period without symptoms
Not much is known about disorder

32
Q

Persistent depressive disorder epidemiology

A

Age of onset: late 20’s
Course: chronic (average lasts about 5 years)
Equal in males and females

33
Q

Cyclothymia epidemiology

A

Very small lifetime prevalence: 0.4%
Course: chronic
Equal occurrence in males and females
Age of onset: adolescence- early adulthood