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Psychopathology > Task 6 - Mood Disorders > Flashcards

Task 6 - Mood Disorders Flashcards

1
Q

Major Depressive Disorder (MDD)

A

Mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and a range of emotional, physical, and cognitive symptoms that significantly impact daily life functioning

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2
Q

DSM-5 Criteria for Major Depressive Disorder

A

A.Five or more of a list of symptoms have been present during the same 2-week period. At least one of the symtoms should be 1) depressed mood or 2) loss of interest/pleasure
B. Cause significant distress
C. Not attributable to substance or other mdeical conditions
D, Is not better explained by other mental disorders
E. There has never been a manic or hypomanic episode

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3
Q

Depression with Anxious Distress

Subtype

A

Characterized by prominent anxiety symptoms alongside depressive symptoms.

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4
Q

Depression with Mixed Features

Subtype

A

Meeting criteria for MDD while having at least three symptoms of mania but not a full manic episode.

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5
Q

Depression with melancholic features

Subtype

A

Emphasizes prominent physiological symptoms of depression.

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6
Q

Depression with Psychotic Features

Subtype

A

Involves delusions and hallucinations related to depressive themes or unrelated/mixed themes.

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7
Q

Depression with Catatonic Features

Subtype

A

Presents with catatonic behaviors ranging from immobility to agitation.

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8
Q

Depression with Atypical Features

Subtype

A

Identified by a unique set of symptoms, not necessarily unusual.

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9
Q

Depression with Seasonal Pattern (Seasonal Affective Disorder, SAD)

Subtype

A

Depressive episodes linked to seasonal changes, specifically light exposure.

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10
Q

Depression with Peripartum Onset

Subytpe

A

Occurs during pregnancy or within 4 weeks post-childbirth, sometimes involving manic episodes.

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11
Q

Premenstrual Dysphoric Disorder

Subtypes

A

Separate from MDD, characterized by severe distress and mood swings during the premenstrual phase

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12
Q

Comorbid disorders of MDD

A

More than 70% with MDD or persistent depressive disorder have other psychological disorders like substance abuse, anxiety, or eating disorders

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13
Q

Genetic factors of Depression

A
  • Studies suggest a potential role of the serotonin transporter gene in depression.
  • Abnormalities in this gene might affect serotonin regulation, impacting mood stability.
  • Recent meta-analysis supports the interaction between the serotonin transporter gene and early stress in predicting later depression.
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14
Q

Caspi et al.: Influence of Life Stress on Depression

A
  • 5-HTT gene may not be directly associated with depression, but it could moderate the serotonergic response to stress
  • Demonstrates that the gene-by-environment (GxE) interaction extends to the natural development of depression in a representative sample of humans.
  • Moderation of life stress on depression was specific to a polymorphism in the 5-HTT gene, and this effect was observed regardless of the individual’s MAOA gene status
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15
Q

Role of Neurotransmitters in MDD

A
  • Norepinephrine, serotonin, and to a lesser extent, dopamine, are associated with depression.
  • These neurotransmitters are highly concentrated in the limbic system, linked to sleep, appetite, and emotions.
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16
Q

Structural and Functional Brain Abnormalities in MDD

A

Prefrontal Cortex: Reduced metabolic activity and gray matter volume, mainly on the left side.
Anterior Cingulate: Altered activity in response to stress and emotional expression.
Hippocampus: Reduced volume and metabolic activity in people with major depression.
Amygdala: Enlargement and increased activity seen in mood disorders.

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17
Q

The HPA axis

Definition

A

Hypothalamic-pituitary-adrenal axis:
* A complex interrelated system in the body responsible for regulating the body’s response to stress.
* It involves the hypothalamus, pituitary gland, and adrenal glands, coordinating the release of hormones like cortisol to manage stress reactions and maintain balance within the body.

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18
Q

Role of the HPA axis in Depression

A
  • Individuals with depression exhibit elevated cortisol and CRH levels.
  • Chronic hyperactivity in the HPA axis contributes to difficulty returning to normal after stress
  • Chronic stress exposure can disrupt neuroendocrine systems, leading to HPA axis overreaction to stressors later in life.
  • This overreaction alters brain neurotransmitter functioning, potentially causing depression.
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19
Q

Salivary Cortisol

A

Way to measure activity of the HPA Axis

20
Q

Potential Reasons for Sex Difference in MDD

A
  • Women’s susceptibility to depression often linked to hormonal changes.
  • Ovarian hormones (estrogen, progesterone) affect neurotransmitter systems influencing mood.
  • Fluctuations in estrogen and progesterone levels during pregnancy, postpartum, and menstruation can impact mood.
21
Q

Learned Helplessness Theory

A

Emphasizes uncontrollable negative events as triggers for depression

22
Q

Aaron Beck’s Cognitive Triad

Concept

A

Individuals with depression perceive themselves, the world, and the future negatively.

23
Q

Reformulated Learned Helplessness Theory

Concept

A

Focuses on how attributions for negative events influence mental states. People who habitually attribute negative events internally, stably, and globally tend to blame themselves, expect more negative events, and perceive a lack of control.

24
Q

Attribution theories

Concept

A

Theories of depression which suggest that people who are likely to become depressed attribute negative life events to internal, stable and global factors

25
Q

Hopelessness Theory

Concept

A

Arises when individuals attribute significant life events pessimistically and feel incapable of coping with the outcomes

26
Q

Ruminative Response Styles Theory

Concept

A

Focuses on how dwelling on negative feelings without addressing their causes contributes to depression.

27
Q

Biases in Attention and Memory

Concept

A

Depressed individuals tend to fixate on negative stimuli and struggle to disengage from them and showcase a bias toward negative memories.

28
Q

Interpersonal difficulties in MDD

A
  1. Deficits in social skills
  2. Need for approval and rejection sensitivity
  3. Excessive Reassurance Seeking
  4. Resultant Behaviors
29
Q

Sociocultural Factors of MDD

A
  1. Cohort effects: Historical and cultural changes might elevate the risk of depression in more recent generations compared to older ones
  2. Gender Differences: WOmen more susceptible
  3. Ethnicity/Race Differences
30
Q

Bipolar I Disorder

Definition

A

Features manic episodes leading to depressive episodes.

31
Q

Bipolar II Disorder

A

Involves hypomania (milder form of mania) and major depressive episodes.

32
Q

Cyclothymic Disorder

Definition

A

Shows chronic, less severe alternation between hypomanic and depressive symptoms.

33
Q

Rapid Cycling Bipolar Disorder

Definition

A

Experiences frequent mood episodes within a year

34
Q

Disruptive Mood Dysregulation Disorder (DMDD)

Definition

A

Severe and frequent temper outbursts inconsistent with developmental levels; requires multiple outbursts in different settings over a specific duration.
(Added because of difficulties diagnosing children with Bipolar)

35
Q

Structural and functional brain abnormalities in Bipolar Disorder

A

Irregularities in:
* Amygdala
* Prefrontal Cortex
* Hippocampus
* Striatum

Circuits out of those could cause symptoms, possibly something to do with reward sensitivity

36
Q

Neurotransmitters involved in Bipolar Disorder

A
  • Monoamine neurontransmitter are implicated
  • Dysregulation in Dopamine systems connected to reward seeking (high in manic episodes, low in depression)
37
Q

Ketamines effect in treating depression

Krystal et al.

A
  • Was thought to help in cortico-limbic pathology of depression
  • Blocks GluN2B-containing NMDA receptors, influencing phosphorylation, BDNF levels, and AMPA receptor movement to synapses, enhancing connectivity
38
Q

Mood stabilizers for Bipolar disorder

A

Mainly lithium, anticonvulsants and atypical antipsychotics

39
Q

Brain Stimulation methods for Bipolar Disorder

A
  1. Repetitive Transcranial Magnetic Stimulation (rTMS)
  2. Vagus Nerve Stimulation (VNS)
  3. Deep Brain Stimulation (DBS)
40
Q

Repetitive Transcranial Magnetic Stimulation (rTMS) for Depression

A
  • Uses high-intensity magnetic pulses targeted at specific brain structures.
  • Focuses on the left prefrontal cortex with low metabolic activity in some depressed individuals.
41
Q

Vagus Nerve Stimulation (VNS) in Depression

A
  • Stimulates the vagus nerve via a surgically implanted electronic device, akin to a pacemaker.
  • Influences areas like the hypothalamus and amygdala involved in depression.
42
Q

Deep Brain Stimulation (DBS)

A
  • Involves surgically implanting electrodes in specific brain areas, connected to a pulse generator under the skin.
  • Small-scale trials demonstrate promise in alleviating treatment-resistant depression.
43
Q

Interpersonal therapy for depression

A

IPT identifies four main problems prevalent in depressed individuals and teaches them techniques to cope with them:
* Grief and Loss
* Interpersonal Role Disputes
* Role Transitions
* Interpersonal Skill Deficits

44
Q

Effects of psychotherapies for Depression in adults

Cuijpers et al.

A
  • Overall response rate of 56%
  • Remission rate of 46%
  • Improvement rate of 66%
  • Type of psychotherapy used did not significantly impact the effectiveness of treatment.
45
Q

Common factors in psychotherapy outcomes

Cuijpers et al.

A
  1. Therapeutic alliance
  2. Patient expectations
  3. Credibility of the treatment
  4. Setting and Context

Psychopathology (9 decks)

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