W3L2: Mood Disorders Part I Flashcards
Depression Characterization
sadness, feelings of worthlessness and guilt, withdrawal from others, neurovegetative symptoms (changes in sleep, appetite and concentration)
Mania Characterization
intense elation or irritability; hyperactivity, talkativeness, distractability
Major Depressive Disorder (MDD) Diagnosis
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
MDD Characteristics
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
Subclinical Depression
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
Persisten Depressive Disorder (Dysthymia)
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
Double Depression
dysthymia plus MDD episode
MDD Gender Differences
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
MDD Epidemiology
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
MDD Comorbidity
2/3 or those with MDD will also meet criteria for anxiety disorder
MDD Generational Factors
vast increase in diagnoses in later cohorts; under diagnosis before or current over diagnosis both possibilities
Bipolar Disorders
involve episodes of depression alternating with mania
Mania
states of intense elation or irritability
Mixed Episode
symptoms of both mania and depression in same week
Hypomania
symptoms of mania but less intense; four or more days of elevated mode; doesn’t interfere with functioning
Bipolar I
at least one episode of mania or mixed episode
Bipolar II
at least one major depressive episode with at least one episode of hypomania
Cyclothymic Disorder
for at least 2 years there have been numerous periods of subthreshold hypomanic and depressive symptoms
Manic and Hypomanic Episodes Diagnosis
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
Bipolar Epidemiology and Consequences
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
Subtypes of Mood Disorders
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)
