Mood Disorders Flashcards
What are the major mood disorders?
Depression and bipolar
List specifiers of a major depressive episode
- psychotic features
- melancholic
- mixed features
- anxious distress
- catatonic features
- atypical features
- peripartum onset
- seasonal pattern
Dysthymia
- depressive symptoms present for more than a two year period (one year for kids and adolescents)
- symptoms can be subsyndromal or meet major depressive episode criteria
List four theories of mood disorders
- Genes and heredity
- Physiological explanations
- Psychological explanations
- Sociocultural explanations
What are two examples of pharmacological treatments?
- anti depressants (SSRIs)
- mood stabilisers e.g. lithium, sodium valporate
What are two examples of psychological treatments?
- cognitive behavioural therapy
- interperosnal psychotherapy (IPT)
What is the connection between bereavement and depression?
Depression is not diagnosed if precipitated by and occurring within six months of bereavement of some sort
Major depressive episode: 5 or more of the following over a 2 week period, at least one depressed mood or diminished interest in activities, and….
- significant weight loss or gain
- insomnia or hypersomnia
- psychomotor agitation
- fatigue
- feelings of worthlessness
- diminished ability to concentrate
- recurrent thoughts of death
List major depressive specifiers
- psychotic features
- melancholic
- mixed features
- anxious distress
- catatonic features
- atypical features
- peripartum onset
- seasonal pattern
What is the prevalence of major depression?
Lifetime prevalence 16%
Prevalence of suicide
4 in 1000
Bipolar disorder 1
At least one manic episode has been experienced
Bipolar disorder 2
At least one hypomanic episode and one depressive episode
Mixed features
When some level of mania and depression cooccur. Higher suicide risk because hopelessness associated with depression is backed up with the energy level and motivational drive of mania.
List the theories of mood disorders
- genes and heredity
- physiological explanations
- psychological explanations
- sociocultural explanations
- existential explanations
Describe genes and heredity as a model of mood disorders
- mood disorders have genetic component
- bipolar disorder seems to share genetic overlap with schizophrenia
- mood disorders and anxiety
Describe physiological explanations as a model of mood disorders
- neurotransmitter functioning and sensitivity (serotonin, noradrenaline, dopamine)
Describe psychological explanations as a model of mood disorders
- stress and trauma
- negative cognitive triad
- learned helplessness
- manic defence hypothesis
- dysfunctional reward sensitivity
Describe sociocultural explanations as a model of mood disorders
- gender bias due to society’s sexism
- tendency for women to internalise responses, men externalise
- emotion focused coping vs. problem focused
Describe existential explanations as a model of mood disorders
There are aspects of modern life that cause conflicts for people and these can lead to depression
List the ways of conceptualising unipolar depression
- depression as lived experience
- depression as illness
- diathesis stress weighting
- diagnostic heterogeneity
List the ways of conceptualising bipolar disorder
- separable traits
- importance of recurrence
What is the ‘manic defence hypothesis’ (as a psychological explanation of mood disorders)
Mania evolved as a compensatory mechanism as depression is highly maladaptive
What is the ‘dysfunctional reward sensitivity’ (as a psychological explanation of mood disorders)
Mania is a response to hyper-activated reward sensitivity, while depression is a response to obstructed reward sensitivity
Hypomanic episode
An attenuated state of mania where similar symptoms are present, but to a lesser extent and duration. Symptoms only present for four days and episode not severe enough for impairment or hospitalisation.
Cyclothymic disorder
- numerous periods of hypomanic and depressive symptoms that do not meet criteria
- symptoms continue for at least 2 years
- present more than 50% of the time and with no more than two months at a time without symptoms
- criteria for full mood episodes must not be met
Name the depressive disorders
- major depressive episode/disorder
- dysthymia
Name the bipolar disorders
- manic episode
- bipolar 1
- bipolar 2
- cyclothymic disorder
- hypomanic episode
- mixed features
Mixed features
Some level of mania and depression
Why does mixed features have a high suicide risk?
The hopelessness of depression is backed up with the energy level and motivational drive of mania
Explain depression as a lived experience
Depression falls on a spectrum with normative experiences of sadness
Explain depression as illness
Depression has a strong biological diathesis that drives the problem
What is the opposite side of depression as illness?
Environnemental components are strong - people who get depressed usually have reasonable stressors to get depressed about
Describe diathesis stress weighting
A spectrum of depression ranging from highly biological to highly situational
Which treatment is best for biological depression
Medication
Which treatment is best for situational depression
Psychotherapy
Describe diagnostic heterogeneity
Depression viewed as a non specific psychological reaction to a whole range of stimuli
What does the DSM not acknowledge when it comes to depression?
- differences between who has had one and who has had 20 depressive episodes
- differences in the weighting of biological diathesis vs. emotional stress
Describe separable traits for bipolar
Can view mania vulnerability and depression vulnerability as separable traits in bipolar disorder
What are some ‘common themes’ of mood disorders
- focus on transient emotional states
- states are viewed as episodic
- importance of recurrence of symptoms
- level of energy and activity cycle affected as strongly as emotional state is
What are the four steps of a suicide risk assessment?
Intent, plan, timeline, means
