Mood Disorders Flashcards
Who identified manic depressive insanity?
Emil Kraepelin.
Who made the distinction between unipolar depression and bipolar depression?
Karl Leonhard.
Define major depressive disorder.
Depressive disorder involving one or more major depressive episodes.
Define anhedonia.
The inability to experience pleasure for previously pleasurable activities.
What must low mood be accompanied by to be diagnosed as major depression? (7)
Significant weight loss when not dieting or weight gain, or a decrease or increase in appetite; insomnia or hypersomnia; loss of energy or fatigue; psychomotor agitation or psychomotor retardation; diminished concentration or ability to think; feelings of worthlessness or excessive or inappropriate guilt; and recurrent thoughts of death, recurrent suicidal ideation without a plan or a suicide attempt or a specific plan for committing suicide.
What is a specifier?
An extension to the diagnosis that further clarifies the course, severity, or special features of the disorder.
Define major depressive episode.
A state characterised by at least five depressive symptoms, one of which must be either sad mood or a loss in pleasure/interest in usual activities.
What is major depressive disorder with melancholic features characterised by? (6)
A profound, nearly complete inability to experience pleasure; worse mood in the mornings; early morning awakening; psychomotor retardation or agitation; anorexia or weight loss; and excessive guilt.
What is major depressive disorder with catatonic features characterised by?
Movement disturbance symptoms, like immobility or excessive, purposeless activity.
What is major depressive disorder with peripartum onset refer to?
Episodes that occur during pregnancy or within four weeks after childbirth.
Give some psychosocial stressors than can cause peripartum onset depression.
Perceived lack of support from their partner, family and friends; feeding and physical difficulties with the infant; stressful life events; previous history of depression and complications during pregnancy.
When is major depressive disorder with seasonal pattern onset diagnosed?
When there is a regular relationship between the onset of the sufferer’s depressive episodes and a particular time of the year.
What is major depressive disorder of mixed features?
Some symptoms of elevated mood are present alongside depression.
What accompanies depression in major depressive disorder with anxious distress?
Significant anxiety, such as irrational worry, inability to relax or a sense of impending threat.
About __% of people with major depressive disorder report significant anxiety symptoms.
50.
What is dysthymia?
A depressive disorder that is less severe than major depression but more chronic.
Give another name for dysthymia.
Persistent depressive disorder.
What is disruptive mood dysregulation disorder?
A depressive disorder characterised by severe and persistent irritability as evident in temper outbursts that are extremely out of proportion to the situation.
Who is disruptive mood dysregulation disorder usually observed in?
Children.
Give the three broad classes of depressive disorders.
Psychotic, melancholic and non-melancholic.
What is melancholic depression characterised by?
The presence of significant psychomotor disturbance.
What is psychotic depression characterised by?
Both psychomotor disturbance and psychotic features.
What are non-melancholic disorders thought to be driven by?
Life event stressors and psychological factors.
Onset of a first episode of depression can occur from as young as:
3
What is early adult depression often preceded by?
An anxiety disorder in childhood or adolescence.
What is conduct disorder?
A disorder marked by chronic disregard for the rights of others including specific behaviour such as stealing, lying and engaging in acts of violence.
What is oppositional defiant disorder?
A disorder of chronic misbehaviour in children marked by belligerence, irritability and defiance.
Give four problems associated with unipolar depression.
Increased risk of suicide and suicide attempts, difficulties performing occupational and social activities, anxiety disorders and physical health problems.
Give some major risk factors for suicide.
Male gender, hospitalisation for depression, comorbidity with a substance use disorder, stressful life events, and a previous history of suicide attempts.
How can inherited traits in children lead to anxiety and depression?
Inherited traits like anxiety can contribute to overprotectiveness and authoritarian parenting, which can undermine a child’s sense of mastery over their environment, creating vulnerability to anxiety and depression.
Which gene is associated with lower efficiency in serotonin reuptake?
A shorter allele of the 5-HTTLPT gene sequence.
What is the effect of having the shorter allele of the 5-HTTLPT gene sequence?
Higher levels of neuroticism and depression after stressful life events or childhood maltreatment.
What are the main neurotransmitters implicated in depression?
Serotonin, norepinephrine and dopamine.
What are serotonin, norepinephrine and dopamine involved in?
The regulation of sleep cycles, motivation and appetite.
What are monoamines?
Neurotransmitters including catecholamines (epinephrine, norepinephrine, dopamine) and serotonin that have been implicated in mood disorders.
What is the limbic system?
Part of the brain that relays information from the primitive brain stem about changes in bodily function to the cortex where the information is interpreted.
How do receptors relate to new theories of depression?
Abnormalities in the number and sensitivity of receptors available to take up monoamine neurotransmitters in synapses, which affects the balance of the available neurotransmitters.
What is the HPA axis?
The hypothalamic-pitutary-adrenal (HPA) axis, which is comprised of three components of the neuroendocrine system that work together in a feedback system interconnected with the brain’s limbic system and cerebral cortex.
Explain the role of the HPA axis in neuroendocrine (hormonal) theories of depression.
People who are depressed tend to demonstrate chronic overactivity in the HPA axis, which results in the production of excess stress hormones, which then affects the way monoamine neurotransmitters work in the brain.
Explain neurophysiological theories of depression.
Structural or functional abnormalities in certain structures in the brain (like the prefrontal cortex, hippocampus, anterior cingulate cortex, and amygdala).
Explain the learned helplessness model of depression.
Depression is a learnt response to adverse events that are perceived as uncontrollable.
What observation is the learned helplessness model based on?
When laboratory animals are subjected to unavoidable adverse outcomes that were independent of their behaviour, they gave up.
What is a depressive attributional style?
An attributional style that interprets negative events as being due to internal, global, and stable factors.
What is the basis of Beck’s cognitive model of depression?
Negative experiences in childhood may result in the development of dysfunctional core beliefs about the self, others and the world.
According to Beck, how do individuals deal with their negative core beliefs?
By adopting compensatory strategies or rules that protect them from developing depression.
How are negative core beliefs triggered?
Relevant negative life events.
Beck believes the thought patterns of depressed people are characterised by: (3)
Self-criticism, a negative view of others and life events, and a pessimistic expectations regarding the future.
