Mood disorders Flashcards
When thinking about MOOD DISORDERS, what is the most basic distinction to think about?
Whether it is unipolar or bipolar
What’s the ‘meh’ form of sadness?
Dysthymia
What’s the name of being basically okay?
Euthymia
What is the main things that distinguishes normal vs clinical depression? (4)
- Intensity
- Absence of precipitants
- Quality
- Associated features (somatic, cognitive)
What led to the development of the DMDD condition in the DSM? (Disruptive Mood Dsyregulation Disorder)
The spike in diagnosis of bipolar in children
For MDE, what are the two things that must be present (one of)?
Depressed mood
Diminished pleasure
Why would a person with the ‘anxious distressed’ specifier of MDD not just get a diagnosis of anxiety?
Because they are only anxious in the context of their depression episodes
What is the leading cause of disability globally?
Depression
What is the rank of depression globally in ‘cause of years lived with disability’?
2
Is depression more common in rich or poor countries?
Same same
What percentage of people have a stable recovery from MDD?
~50%
Wth MDD, how many people exhibit a chronic course?
~15%
With MDD, how many people exhibit a recurrent course?
30-60%
For what subtype of MDD might you prescribe an SNRI?
Anhedonia types
What did we learn rom the STAR*D study?
- If you fail medication once, you very unlikely to have another one work
- the more treatments you fail, the more likely you are to fail other treatments
What percentage people who suicide have MDD?
60%
What is the risk factor or suicidality for people with relatives who have suicided? Or with MDD?
OR 1.7-10.6
What was PERSISTENT DEPRESSIVE DISORDER (PDD) a replacement for?
Dysthymia
What is the treatment for PERSISTENT DEPRESSIVE DISORDER (PDD)?
Same like MDD
Is PERSISTENT DEPRESSIVE DISORDER (PDD) more or less likely than MDD to be treatment resistant?
More
Why is PERSISTENT DEPRESSIVE DISORDER (PDD) often under-treated?
Because it becomes part of the person’s everyday experience and so they don’t seek treatment
What treatments are offered for PMDD?
SSRIs
Hormones
CBT
What the heritability of unipolar depression?
40-70%
First-degree relatives of depressed individuals have a risk of …% of also eveloping depression
5-25%
Name a brain region apparently linked to depression
Hippocampus
But this is also linked to other psychiatric disorders
How common are stressors in depressed patients?
2.5 x more likely
What percentage of MDEs are preceded by major life event?
80%
What is contained in Beck’s negative triad?
World
Self
Future
What’s the different between Ellis and Beck?
Ellis goes hard into the schema
Beck goes to negative’s automatic events
What are five depressogenic schemas that were on the slides?
- Fear of losing control
- Fear of abandonment
- Social undesirability
- Incompetence
- Deserve to be punished
What is the difference between bipolar I and Bipolar II
Bipolar II has not mania (only hypomania)
In Bipolar I you don’t HAVE to have a MDE
Does mixed features appear in Bipolar I or Bipolar II?
Both!
What is CYCLOTHYMIA?
Two years of low lying symptoms (neither extremes)
What are the most common clinical features of BIPOLAR?
During manic episodes
- Elevated or irritable mood
- Excessive activity
- Racing thoughts
- Reduced need for sleep
During depressive episodes
- Dysphoria with anhedonia
- Suicidal ideation
- Loss of energy
- Poor concentration
- Initial insomnia
- Diminished libido
What are the BIPOLAR classifiers
- Mixed features:
- Depressive and manic features present during same episode
- Anxious distress
- Significant anxiety
- Catatonia (unusual movement)
- Melancholic features (profound sadness)
- ’Atypical’ features
- Rapid cycling
What are some linked between BIPOLAR and PSYCHOSIS type symptoms?
- 89% had experienced psychotic symptoms
- 20.5% experienced hallucinations
- 85.7% had experienced delusions
What is the best approach to treating BIPOLAR?
A mix of drugs and therapy
