W3L2: Mood Disorders Part I

Question 1

Depression Characterization

Answer 1

sadness, feelings of worthlessness and guilt, withdrawal from others, neurovegetative symptoms (changes in sleep, appetite and concentration)

Question 2

Mania Characterization

Answer 2

intense elation or irritability; hyperactivity, talkativeness, distractability

Question 3

Major Depressive Disorder (MDD) Diagnosis

Answer 3

MUST have depressed mood or anhedonia (loss of interest or pleasure) for minimum of two weeks not due to normal bereavement
MUST also have four of:
change in sleep patterns
change in appetite or weight gain
psychomotor agitation or retardation
loss of energy, fatigue
feelings of worthlessness or excessive/inappropriate guilt
difficulty concentrating, indecisiveness
thoughts of death, recurrent suicidal ideation

Question 4

MDD Characteristics

Answer 4

episodic (symptoms tend to dissipate over time)

recurrent (one episode makes future episodes more likely); high risk if someone struggles with an episode in adolescence

Question 5

Subclinical Depression

Answer 5

Sadness plus 3 other symptoms for three days (not enough symptoms or duration) can still have impairment even if fully doesn’t meet diagnosis; should seek help

Question 6

Persisten Depressive Disorder (Dysthymia)

Answer 6

chronic depression (depressed mood for 2 years or more without MDD)
PLUS two of:
poor appetite or overeating
sleeping too much/too little
psychomotor agitation or retardation
loss of energy
feelings of worthlessness
difficulty concentrating or indecisiveness
recurrent thoughts of death or suicide

95% develop MDD

Question 7

Double Depression

Answer 7

dysthymia plus MDD episode

Question 8

MDD Gender Differences

Answer 8

twice as common in women as in men, difference emerges in adolescence
possible factors:
hormones
girls more likely to experience sexual abuse (shown to have large effect size)
women more likely to experience chronic factors and worry about body image
women react more intensely to interpersonal loss
women spend more time ruminating

Question 9

MDD Epidemiology

Answer 9

symptom variation across cultures; latino cultures complaints of nerves and headaches; asian cultures complaints or weakness, fatigue, poor concentration
symptom variation across lifetime; children have stomach and head aches; older adults have distractibility and forgetfulness

Question 10

MDD Comorbidity

Answer 10

2/3 or those with MDD will also meet criteria for anxiety disorder

Question 11

MDD Generational Factors

Answer 11

vast increase in diagnoses in later cohorts; under diagnosis before or current over diagnosis both possibilities

Question 12

Bipolar Disorders

Answer 12

involve episodes of depression alternating with mania

Question 13

Mania

Answer 13

states of intense elation or irritability

Question 14

Mixed Episode

Answer 14

symptoms of both mania and depression in same week

Question 15

Hypomania

Answer 15

symptoms of mania but less intense; four or more days of elevated mode; doesn’t interfere with functioning

Question 16

Bipolar I

Answer 16

at least one episode of mania or mixed episode

Question 17

Bipolar II

Answer 17

at least one major depressive episode with at least one episode of hypomania

Question 18

Cyclothymic Disorder

Answer 18

for at least 2 years there have been numerous periods of subthreshold hypomanic and depressive symptoms

Question 19

Manic and Hypomanic Episodes Diagnosis

Answer 19

elevated, expansive, or irritable mood and abnormally and persistently increased goal directed activity and energy
PLUS 3 of:
inflated self-esteem or grandiosity
decreased need for sleep
more talkative than usual or pressure to keep talking
flight of ideas or experience that thoughts are racing
distractibility (reported or observed)
Increase in goal directed activity or psychomotor agitation
excessive involvement in activities that have high potential for painful consequences
Manic Episode: symptoms last 1 week or require hospitalization, cause significant distress or functional impairment
Hypomanic Episode: symptoms last at least 4 days and clear changes in functioning but impairment is not as marked

Question 20

Bipolar Epidemiology and Consequences

Answer 20

lower prevalence than MDD (1% for Bipolar I)
Average onset in 20s
No gender differences
Tends to be recurrent
Severe mental illness (unemployment high)
High suicide rates

Question 21

Subtypes of Mood Disorders

Answer 21

Rapid Cycling: at least 4 mood episodes in 1 year
Postpartum Onset: within 4 weeks after giving birth
Catatonic Features: extreme physical immobility or excessive peculiar physical movement
Psychotic Features: delusions or hallucinations
Melancholic: inability to experience pleasure (anhedonia)