Week 7 - Mood Disorders Flashcards
What is the diagnostic criteria for depression?
- Five or more of the symptoms listed for depression in DSM-5
- Symptoms present during same 2-week period
Describe the prevalence of depression in the UK
- 12-month prevalence suggests 5-7% of adults in the UK
- Research suggests young adults have three times higher prevalence than individuals aged 60+
- Research also suggests that prevalence rate is 1.5-3 times higher for reported symptoms of depression relative to men
- Lifetime prevalence for unipolar depression approx. 18% in western populations
What is Persistence Depressive Disorder (Dysthymia)?
Chronic symptoms of depression, lasting at least two years
What are depression’s aetiological/risk factors?
- Biological Factors: Genetics, Regulatory dysfunction, etc.
- Psychological Factors: Beliefs/cognitive schema, Rumination, Optimism/pessimism, etc.
- Social Factors: Attachment, Trauma/loss, Parental psychopathology, etc.
What are the cognitive theories of depression?
- Distorted ways of thinking develop in childhood stage and place one at increased risk for depression later in life
- The Cognitive Triad
- Cognitive-Behavioural Maintenance Cycle
Explain the Cognitive Triad
- Negative View of Oneself
*Perceive self as worthless, unlovable and lacking skills required to obtain happiness - Negative View of the Environment/Present
*Perceive environment as posing excessive demands or obstacles that are impossible to overcome and lead to failure - Negative View of the Future
*Perceive future as hopeless and believing one is hopeless to effect change
Explain the Cognitive-Behavioural Maintenance Cycle
- Feeling depressed
- Negative thoughts (ex. not finding things enjoyable)
- Withdrawal from activity (ex. social, work)
- Reduction of positive rewards for engaging in activity (less experience of pleasure, achievement or social acceptance)
- Cycle repeats
What is the recommended treatments for depression, according to NICE (2009)?
Step 1: Recognition and Assessment
Step 2: Persistent subthreshold depressive symptoms; Mild to moderate
*Low-intensity psychosocial interventions, psychological interventions, medication and referral for further action
Step 3: Persistent subthreshold depressive symptoms; Moderate and severe depression
*Also for those with mild-moderate but gave inadequate response to initial interventions
*High-intensity psychological interventions, medication, combined treatments, collaborative care and referral for future action
Step 4: Severe and complex depression; Risk to life; Severe self-neglect
*High-intensity psychological interventions, medication, electroconvulsive therapy?, crisis service, combined treatments, multi-professional and professional care
Antidepressants
- Widely utilised (in 2017-2018, approx. 7.3 million people in the UK had one or more prescriptions issued)
- Increases neurotransmitters in the brain; Regulating chemicals like serotonin and noradrenaline in the brain
- Used to help regulate mood
- Are not always immediately effective (may take weeks to experience full effects)
Side Effects of Antidepressants
Explain Monoamine Oxidase Inhibitors (MAOIs; Antidepressants)
- Monoamines are a category of neurotransmitters (monoamines: serotonin, dopamine, norepinephrine, epinephrine)
- MOAIs bind to enzymes to prevent breakdown of monoamines
- Mechanism: Dopamine released at the synapse, attaches to receptors, but after its done doing its job it gets reabsorbed into the prior synapse but instead of it being available for later use it gets destroyed by the MAOI
Diagnostic Criteria for Depression
- Depressed mood most of the day, nearly every day.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
- Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
- A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Diagnostic Criteria for Bipolar Disorder: Manic Episode
- Distinct period of abnormally and persistently elevated, expansive, or irritable mood AND abnormally and persistently increased goal-directed activity or energy
- lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalisation is necessary)
- Mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalisation to prevent harm to self or others, or there are psychotic features
- During the period of mood disturbance and increased energy or activity, three or more of the following symptoms (four if mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressure to keep talking
- Flight of ideas or subjective experience that thoughts are racing
- Distractibility (reported or observed)
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in activities that have a high potential for painful consequences
Diagnostic Criteria for Bipolar Disorder: Hypomaniac Episode
- A distinct period of abnormally and persistently elevated, expansive or irritable mood AND abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day
- Displays 3 of the symptoms assessed in Manic episode
- The episode is associated with unequivocal change in functioning
- The disturbance in mood and change in functioning are observable by others
- Episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization
What are the three Bipolar Disorders and its Related Disorders?
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
