Mood Disorders Flashcards
Years Lost Due to disability. Where does depression sit?
1990: It was first
2020: It will be (is) second.
Disruptive Mood Dysregulation Disorder
Introduced to stop kids getting diagnosed with Bipolar disorder. Based on irritable mood (without elevated mood).
If someone has never had depressive episodes (only manic), can they receive a diagnosis of bipolar?
Yes!
How much time constitutes a “depressive episode”?
2 weeks.
Anhedonic depression (opposed to low mood) more common in…
men.
Depression prevalence in children:
2%
Depression prevalence in adolescents:
1 in 10 to 1 in 4 experienced by end of adolescence
Depression prevalence in adulthood:
Lifetime 17%
Men:Women
1:2 (twice as many women)
Average duration of MDD:
7 to 9 months 60-70% improve within 3 months
Risk indicators?
Adolescent onset and suicidality
average number of episodes?
5-6
Depression diagnosis in elderly is underdiagnosed?
symptoms often masked by other ailments
Why do women suffer depression more?
Women internalise, men externalise (alcoholism), more exposed to risk factors (demostic violence, poverty), societal burden on women increasing
Bipolar I lifetime prevalence
1.6%
Bipolar II lifetime prevalence
2%
Mean age of onset of bipolar
21 yoa
M:F ratio of bipolar I
1:1
Depression to mania ratio bipolar I
3:1
M:F ratio of bipolar II
more common in women
Depression to mania ratio bipolar II
50:50
How many episodes per year for bipolar I?
0.4-0.7 episodes per year
Biological factors for depression?
Twin concordance rate for twins is almost 50%
Fraternal twin - 20%
Does having a depressive twin raise likelihood of having bipolar yourself?
No. No increased risk of bipolar from genetic endowment.
Does having a bipolar twin raise likelihood of having depression?
Yes. Bipolar genetic endowment increases risk of depression.
Neurochemical factors…
Norepinephrine - depression and mania
Serotonin - in depression (regulates other neurotransmitters)
Dopamine - leads to depression, increase mania
Lithium use suggests Norapinephrine involvement
Endocrine system - “Stress hypothesis”
- Overactivation HPA axis
- Neurohormones
- Elevated cortisol
- Supported hippocampal neurogenisis
Psychological factors focus on…
meaning of events (cognitive approach)
For what was CBT developed to treat?
Depression.
What did Seligman do?
learned helplessness theory - people make attributions or explanations for events
Beck?
shit covered glasses - “everything sucks” -
these cognitions are reliably associated with depression.
Beck thinks depressed state is due to these cognitions.
Who invented CBT?
Beck!
Negative triad?
Self - defective, deprived, inadequate - “I am useless”
World - demanding, presenting hurdles - “Nothing ever goes right for me”
Future - anticipates difficulties and struggles will continue - expects hardship, frustration, deprivation - “It will always be like this”
Course of CBT
10-20 sessions - time limited and goal directed
Behavioural aspect of CBT
get person activated and doing activities if reduced
- scheduling activities
- increase positive events that give pleasure and/or achievement
Cognitive aspect of CBT
- identify unhelpful patterns of thinking
- identify characteristic unhelpful styles, substitute more adaptive thoughts
- correct negative cognitive schemas - underlying beliefs that drive thoughts in many life situations
What is a genogram?
graphic representation of family tree that displays detailed data on relationships among individuals.
How does CBT work?
- challenges depressive cognitions such as being ineffectual or unable to gain satisfaction from life
- disconfirms depressive distortions through pleasurable and satisfying activities
- focuses on activity assessment and increasing mastering and pleasure.
What is Socratic questioning?
graded series of questioning to facilitate independent thinking
-progressive series asked to shape client’s thought processes
