week 2 Flashcards
How are mood disorders set out in the DSM?
Used to be just one section, but now divided into depressive disorders and bipolar and related disorders.
The main diagnosis is MDD and bipolar.
Common themes of the DSM-5 on mood disorders
Focus on transient emptional states, AKA mood
These states are viewed as episodic (though they can be long)
importance of recurrence of symptoms
level of energy and activity cycle affacted as strongly as emotional state is
MDE criteria
Five or more of the set of symptoms (inc on a different card) must have been present during the same 2 week period, and is a change in previous functioning, and at least one of the symptoms is either 1, depressed mood, or 2, loss of interest of pleasure.
MDE criteria LIST
- depressed mood most of the time, sad, empty or hopeless
- anhedonia/no pleasure in anything
- weight loss/gain
- insomnia
- psychomotor agitstion, or retardation nearly everyday
- fatigue or loss of energy
- diminished ability to concentrate
- feelings of worthlessness or guilt
- recurrent thoughts of death, suicidal ideation
MDD criteria
at least one MDE has to have ben experienced, and its not better explained by something else.
What is another term for MDD?
unipolar depression, though this is just to distinguish it from the depresion that comes with bipolar
What are some specifiers for MDD?
Can be some psychotic elements, melancholic, mixed features (overlap with mania), anxious distress, catatonic distress, atypical features, peripatrum onset etc
Persistent depressive disorder
AKA Dysthymia.
Depressive symtpoms present for more than a twp year period (1 year for kids)_.
Symptoms can be subsyndromal or meet MDE crtieria. If meeting MDE crtieria, can do so persistently or intermittently.
Depression and all her babies prevelance
High prevelance, 16% lifetime prevelance. Mean age of onset is 30yrs. Prevelance increases in early adolescence though. about 70% suffers are female. typical episode duration 2-9 months if untreated
How does bereavement play into this?
in DSM 4, depression wasn’t diagnosed if there’d been a death in the 6 months before the Big Sads. However, DSM-5 doesn’t describe a time limit, but advises consideration of signs. Depression is understandable in most of these cases, so do we need to slap a lable on them?
Suicide
You do not need to be clinically depressed to commit suicide. Its impossible to know real numbers of suicide (accident or on purpose?) but the current estimate is 4 in 1000, but thats probably way under.
Occurs in all age groups, hopelessness is a big factor.
What is Bipolar?
Similar to depression, but episodes of mania experienced too. Often recurrent, rarely just the one episode. Has a strong biological influence. Multiple types
What are the different types of bipolar
Type 1, Type 2, cyclothymic disorder
Manic episode criteria
A distinct period of abnormally and persistently elevated, irritable, expansive mood, and abnormally increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.
During the period of mood disturbance and energy, THREE or more of the following symptoms (or FOUR if the mood is irritable) are present to a significant degree, and are a change from behaviour.
1. inflated self esteem
decreased need for sleep
insanely chatty
flight of ideas or subjective experience that thoughts are racing
distractability
increase in goal directed activity
excessive involvement in activites that have high potential for painful consequences
WHat is hypomania, and what is its crtieria
Hypomania is mania lite. Essentially, shorter periods of mania and symptoms aren’t as strong or life destroying. Same criteria as a manic episode, BUT, symptoms only need to be present for four days, and the episode isn’t enough to cause social, occuaptional imapriment, or hospitalisation, though others should notice the person is being a bit whacky
Bipolar disorder I criteria;
at least one manic epsoode has been experienced, knowing that depression is more than likely to come later
Bipolar disorder 2
At least one hypomanic episode and one depressive episode has been experienced
Similarities between B1 and B2
Both have rapid cycling, both usually have depressive episode at the start.
Cyclothymic disorder
recurrent sub-threshold mood variability. Numerous periods of hyppmanic symptoms that do not meet hypomanic cirteria, and depressive symptoms that dont meet MDE criteria). Symptoms go for at least 2 years (1 in kids). Symptoms present half the time, and with no more than 2 months without symptoms. Criteria for full mood episodes must not be met.
Mixed features
Grouped differently to bipolar. Essentially, when some level of mania and depression co-occur. Relatively common, and higher suicide risk because you have the hopelessness of depression mixed with energy and motviation of mania. Sufferers also likely to experience symptoms even when in standard functioning.
Bipolar prevelance
Low prev, 1%. Equal across genders, though comorbid anxiety, rapid cycling, and more depression is in women. Similar prevelance in kids but this is controverssial.
Depression and the diathesis stress model
Most depression is related to environmental triggers, not really a chemical imbalance most of the time. Those that do have biological causes will suit meds, but those who are just bloody going through it are much better off seeing a shrink and making life changes. situational dep much more common than bio
How to conceptualise depression
Depression is probably best viewed as a nonspecific psychological reaction to stimlui; think of it like how cold symptoms show up for a bunch of viruses. DSM offers no room for wigglign between someone with 1 MDE and someone whose had 20.
Is bipolar, in fact, polar?
Nup. Bipolar disorder does not have two poles.
Remember that mania is NOT the opposite of depression. You can be having a manic episode that has elements of depression.
Bipolar and genes
mood disorders are a lil genetic, twin studies indicate to be the spot. Ideas that the Serotonin transporter gene tends to be implicated, but its not just gunna be one gene. perhaps too sensitieve neurotransmitters?
biological weird shit with mood disorders
Neurotransmitter functioning and sensitivity – the biogenic monoamines (serotonin, noradrenaline, dopamine)•Disrupted endocrine system reflected in hypothalamic-pituitary-adrenal axis (regulates stress hormones)•Sleep and circadian rhythm abnormalities•Frontal electroencephalogram (EEG) asynchrony
psycho explanations
stress, trauma. Negative cognitive triad (thoughts of self, others and world).
Learned helplessness?
Manic defence hypoithesis
Sociocultural explanation
the differences in sexes due to societal shit.
