Mood Disorders Flashcards

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1
Q

How do mood disorders differ from mood?

A

Disorders involve disabling mood disturbance. Differs from sadness/happiness in intensity, duration, impairment and associated symptoms.

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2
Q

What qualifies as a major depressive episode?

A

≥ 5 symptoms, nearly daily, for ≥ 2 weeks

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3
Q

Defining characters of major depressive episode

A

Sad/depressed OR loss of interest in usual activities (anhedonia)

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4
Q

Symptoms of major depressive episode

A
  • Significant change in weight or appetite
  • Difficulties in sleeping
  • Psychomotor retardation/agitation (slow down/can’t sit still)
  • Loss of energy or fatigue
  • Worthlessness or guilt
  • Difficulty concentrating or making decisions
  • Recurrent thoughts of suicide or death
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5
Q

Major depressive disorder (MDD)

A

≥ 1 episode of depression

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6
Q

Lifetime prevalence of MDD

A

16% (most common in 18-29 year olds)

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7
Q

Average age of onset of MDD

A

25 years

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8
Q

Sex/cultural differences in MDD

A
  • Affects rates and presentation of symptoms
  • Greater in women, Latinx/Hispanic
  • Less in African Americans
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9
Q

Persistent depressive disorder

A

Milder depressed mood for most of the day more days than not for ≥ 2 years

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10
Q

Premenstrual dysphoric disorder

A

Severe, disabling form of PMS

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11
Q

Biological factors for MDD

A

35% heritability. Involves genetic, neuroendocrine and neurotransmitter related factors.

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12
Q

Genetic factors for MDD

A
  • Multiple genes

- Interact with environmental stress

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13
Q

Neuroendocrine factors for MDD

A
  • Chronically elevated cortisol
  • HPA hyperactivity
  • Related to early stress (childhood stress)
  • Reduces neurogenesis (generation of neurons)
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14
Q

Neurotransmitters involved in MDD

A
  • Low serotonin = poor regulation of sleep, emotion, appetite
  • Permissive hypothesis = serotonin -> dysregulation of norepinephrine and dopamine
  • Balance of NTs important
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15
Q

Beck’s negative cognitive triad

A

Negative views of self, world, future

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16
Q

Cognitive distortions

A
  • All or nothing: it’s all bad
  • Catastrophizing: thinking the worst will happen
  • Mental filter: dwelling on negative details
  • Overgeneralization: a negative event is likely to happen again and again
  • Personalization: self-blame
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17
Q

Learned helplessness theory

A

Serves as a behavioral explanation. People may become depressed because they learn to view
themselves as helpless to control their environment.

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18
Q

Cognitive vulnerabilities

A
  • Negative cognitive triad
  • Internal, stable and global attributions
  • Rumination
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19
Q

Internal attribution

A

Blaming oneself for a situation

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20
Q

Stable attribution

A

Event was due to unchanging, permanent factors and will happen again

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21
Q

Anxious features subtype of depression

A

Prominent anxiety symptoms as well as depressive symptoms

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22
Q

Mixed features subtype of depression

A

Meet the criteria for a major depressive disorder and have at least 3 symptoms of mania, but they do not meet the full criteria for a manic episode.

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23
Q

Melancholic features subtype of depression

A

Physiological symptoms of depression are particularly prominent (e.g. weight loss, psychomotor retardation); anhedonia

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24
Q

Psychotic features subtype of depression

A

Experience delusions and hallucinations; can be mood-congruent (related to typical themes of depression such as worthlessness) or mood-incongruent

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25
Q

Catatonic features subtype of depression

A

Catatonic behaviors: not actively relating to environment, mutism, posturing, agitation, mimicking another’s speech or movements

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26
Q

Atypical features subtype of depression

A

Odd assortment of symptoms (e.g. positive mood reactions to some events, significant weight gain or increase in appetite, hypersomnia, sensitivity to interpersonal rejection)

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27
Q

Seasonal pattern subtype of depression

A

History of at least two years in which major depressive episodes occur during one season of the year (usually the winter) and then the person fully recovers when the season is over (e.g. SAD)

28
Q

Peripartum onset subtype of depression

A

Onset during/after pregnancy

29
Q

Global attribution

A

Will happen in many situations (e.g. I lost my job, so everything else in my life will also go wrong)

30
Q

Rumination

A

Repetitive focus on emotions and symptoms of distress and their causes and consequences - lead to increased awareness and reduced problem solving

31
Q

Beck’s model

A

Negative core beliefs (about self, world or future) + negative event -> automatic negative thoughts (cognitive distortions) -> emotion (depression)

32
Q

Basic cognitive model of depression

A

Stressful life events -> negative automatic thoughts = cognitions -> depression

33
Q

Reformulated learned helplessness theory

A

Negative event -> causal attribution (internal, stable or global) -> depression/helplessness

34
Q

CBT Treatment Targets

A

Targets automatic negative thoughts through cognitive restructuring and withdrawal through behavioral action

35
Q

Behavioral activation

A

Pleasant activity scheduling, and tracking and planning the engagement in activities that are reinforcing

36
Q

Cognitive restructuring

A

Learn to recognize and change distorted thinking patterns. Identify automatic thoughts and distortions, rationally dispute them (Socratic method) and develop rational rebuttal to automatic thoughts.

37
Q

Methods to cognitive restructuring

A
  • Thought diaries to monitor negative automatic thoughts.
  • Challenge the validity of thoughts
  • Replace cognitive distortions with more adaptive thoughts
  • Change core beliefs
38
Q

Medications for depression

A
  • SSRIs (e.g. prozac)
  • SNRIs (e.g. cymbalta)
  • Atypical antidepressants (e.g. trazodone)
  • Tricyclic antidepressants (e.g. doxepin)
  • MAOIs (e.g. phenelzine)
39
Q

Bipolar I

A

Experiences full symptoms of mania and their manic episodes last 7+ days; depressive aspects may be more infrequent or mild.

40
Q

Bipolar II

A

Experience severe episodes of depression that meet the criteria for major depression, but their episodes of mania are milder and are known as hypomania; hypomania is not severe enough to interfere with daily functioning, does not involve hallucinations or delusions, and lasts at least 4 consecutive days

41
Q

Characteristics of bipolar disorder

A

Persistent elevated mood/euphoria OR irritability

42
Q

Symptoms of mania

A
  • Inflated self-esteem
  • Decreased need for sleep
  • Talkative, rapid speech
  • Racing thoughts
  • Distractibility
  • Increased goal-directed activity/ psychomotor agitation
  • Excessive pleasurable, potentially damaging activities
43
Q

Factors involved in bipolar disorder

A
  • Heritable; relatives 5-10x likelier to have bipolar disorder
  • Neural
  • Neurotransmitters
  • Psychosocial
44
Q

Neural factors for bipolar disorder

A
  • Reduced prefrontal cortex
  • Abnormal amygdala
  • Abnormal striatum (involved in motor and reward systems)
45
Q

Neurotransmitters implicated in bipolar disorder

A

Dysregulation of dopamine

46
Q

Psychosocial factors of bipolar disorder

A
  • Stress
  • Positive events
  • Changes in routine (e.g. sleep, eating, social)
47
Q

Cyclothymic disorder

A

Milder but more chronic form of bipolar disorder

48
Q

Biological treatments for bipolar disorder

A
  • Lithium
  • Anticonvulsants
  • Atypical antipsychotics
49
Q

Psychological treatment for bipolar disorder

A
  • Psychoeducation (providing information to those seeking/receiving mental health services)
  • Interpersonal and Social Rhythm: Social skills, reduce social stress; regular sleep, eating, activity; self-monitoring
50
Q

Does bipolar relate to creative eminence?

A

Studies examining biographies suggest it is overrepresented in famous artists

51
Q

Are those with bipolar rated as highly creative?

A
  • Those with cyclothymic had more creative achievements than controls
  • Those with bipolar I no different from controls
52
Q

Bipolar and creativity: personality characteristics

A
  • Impulsivity
  • Openness to experience
  • Confidence
53
Q

Bipolar and creativity: positive emotions

A
  • Relaxes inhibition

- Increases awareness and flexibility

54
Q

Bipolar and creativity: specific symptom presentation

A

Elevated mood, decreased sleep, increased energy

55
Q

Suicide

A

The intentional ending of one’s own life

56
Q

Suicide attempt

A

Harm with intent to die

57
Q

Ideation

A

Thoughts about suicide

58
Q

Non-suicidal self-injury (NSSI)

A

Harm without intent to die

59
Q

Suicide statistics

A
  • 11th leading cause of death in the United States
  • 3rd leading cause of death in teenagers in US
  • 2nd leading cause of death for age 15-34 in Canada
60
Q

Suicide in males

A
  • More likely to die by suicide
  • Highest ages 40-59
  • Firearms most common method in US/Hanging in
    Canada
61
Q

Suicide in females

A
  • More likely to attempt suicide (3-4x more likely in Canada)
  • Highest ages 40-59
  • Poisoning most common method in US and Canada
    (hanging close behind in Canada)
62
Q

Demographic risk factors for suicide

A

Male; widowed, divorced, single; increases with

age; born in Canada, indigenous

63
Q

Genetic and familial risk factors for suicide

A

Family history of suicide, mental illness, or abuse

64
Q

Psychiatric risk factor for suicide

A

Substance abuse

65
Q

Psychosocial risk factors for suicide

A

Lack of social support; unemployment; drop in

socio-economic status; firearm access

66
Q

Behavioral dimensions risk factors for suicide

A

Impulsivity; prior suicide attempt; NSSI

67
Q

Myths about suicide

A
  • Talking about suicide increases the likelihood someone will kill themselves
  • People who attempt suicide are intent on dying
  • If they’re talking about it, they won’t actually do it
  • People are often most vulnerable when they are at their most severely depressed