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z. z. PSY3032 Lectures - Abnormal Psychology > Week 8 Lecture 8 - Depressive Disorders - Summary (DN) > Flashcards

Week 8 Lecture 8 - Depressive Disorders - Summary (DN) Flashcards

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1
Q

What differentiates Bipolar disorders from Depressive Disorders?

A

Presence of Mania

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2
Q

Which disorders are amongst the most common of the psychological disorders?

A

mood disorders

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3
Q

What is the key identifying feature of Bipolar Disorder?

A

alternation of manic episodes & major depressive episodes

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4
Q

Why are the specifiers (subtypes) useful?

A

they may predict course or response to treatment

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5
Q

What causes mood disorders?

A
  • Complex interaction of biological, psychological & social factors
  • Stress hypothesis & neurohormones
  • Learned helplessness, cognitive schemas Interpersonal disruptions
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6
Q

What are effective treatments?

A
  • biological & psychological both effective
  • combined = further 20% improvement
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7
Q

What psychological therapies are effective in treating Depressive Disorders?

A

Cognitive & interpersonal therapies

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8
Q

What is the long term prognosis for mood disorders?

A

relapse is common

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9
Q

What are the subset of the mood disorders that involve manic symptoms referred to as?

How are these differentiated?

A
  • Bipolar
  • Differentiated by intensity, duration & type of symptoms

0:50

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10
Q

What are disorders that only involve depressive symptoms commonly referred to as?

How are these disorders differentiated?

A
  • Unipolar
  • Differentiated by the severity & duration

0:33

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11
Q

What are the two main ‘mood disorder’ categories in DSM-5?

A
  • Depressive disorders
  • Bipolar and related disorders

0:22

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12
Q

What are the defining features of Depressive Disorders?

A
  • profound sadness
  • inability to experience pleasure
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13
Q

What are some really important components in the diagnosis of Major Depressive Disorder?

A
  • Must not have had a manic episode
  • needs to be almost all of the time for at least 2 weeks

5:00

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14
Q

What is the time course for Major Depressive Disorder?

A
  • an episodic disorder
    • symptoms come & go
  • although can drag on for months
  • tends to recur

5:00-7:00 approx

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15
Q

What are the defining features of Dysthymia (Persistent depressive disorder)

A
  • persistent, chronic, depressed mood
  • no relief
  • more than 2 years
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16
Q

How does Dysthymia differ from Major Depressive Disorder?

A

Dysthymia (persistent depressive disorder)

  • 2 symptoms 2 years (1yr for child)
  • chronic

Major Depression

  • 5 Symptoms, 2 week period
  • episodic
17
Q

What are the 4 Depressive Disorders covered in the lecture?

A
  • Major Depressive Disorder
  • Dysthymia (Persistent Depressive Disorder)
  • Premenstrual Dysphoric Disorder
  • Disruptive Mood Dysregulation Disorder
18
Q

Which two Depressive Disorders are new to DSM-5?

A
  • Premenstrual Dysphoric Disorder
  • Dysruptive Mood Dysregulation Disorder
19
Q

What are the defining features of Premenstrual Dysphoric Disorder?

A
  • affect up & down (moody)
  • impacted concentration, energy, sleep, appetite, physical pain
  • must cause significant distress/impairment
20
Q

What are the defining features of Disruptive Mood Dysregulation Disorder?

A
  • Chronic, severe & persistent irritability
  • negative mood in at least 2 settings,
  • 12 months, most of the time
  • no mania

Behaviour extreme

  • recurrent temper outbursts
  • inconsistent with developmental level
  • must be differentiated from other disorders

14:45

21
Q

What other disorders often coexist with Major Depressive Disorder & Dysthymia?

A
  • Anxiety Disorder
    • 60% Depressives also have anxiety
  • Substance-related disorders
  • Sexual dysfunction
  • Personality disorders
  • Cardiovascular disease
22
Q

How do symptoms of Depressive Disorders behave across the lifespan?

A
  • Symptoms change over lifespan
  • children → somatic complaints
  • older adults → distractibility & memory loss
23
Q

Why are the MDD & BP disorder subtypes (specifiers) useful to a clinician?

A

enables them to build up a heterogeneous (individual) picture of how an individual may be presenting

48:10

24
Q

How does a manic episode differ from a hypomanic episode?

A

Manic

  • Significant impairment
  • psychotic symptoms
  • Symptoms - 1 week or hospitailisation
  • cause distress/functional impairment

Hypomanic

  • Impairment not marked but observable to others
  • no psychotic symptoms
  • at least 4 days
  • no hospitalisation
25
Q

What has been hypothesised about the role of neurotransmitter serotonin in the aetiology of mood disorders?

A

BALANCE of neurotransmitterrs is important

Serotonin’s primary function - regulate emotional reaction

  • lower levels seen in mood disorders
  • decreased serotonin
    • thought to lead to dysregulation in other neurotransmitters
  • when serotonin is low
    • it allows other neurotransmitters are able to range more widely
    • leads to imbalance

1:08:40

26
Q

Which neurotransmitter has been thought to contribute to hypomania & depression?

What has been found to trigger instability in this neurotransmitter?

A

Dopamine agonist (L Dopa)

Hypomania

  • Increased Dopamine levels > oversensitive receptors?

Depression (atypical & with psychotic features)

  • Decreased Dopamine levels

Possible Triggers to imbalanced Neurotransmitters:

  • Chronic Stress has been linked to reduced Dopamine levels & depression
26
Q

What factors have been described in the Aetiology of Mood Disorders?

What theories have tried to explain these disorders?

A
  • Neurobiological factors, including:
    • Genetic factors
    • Neurotransmitters
    • Neuroimaging
    • Neuroendocrine system
  • Social factors
  • Psychological factors
  • Personality factors

Theories

  • Cognitive theories
  • Learned helplessness
27
Q

What distinguishes Disruptive Mood Dysregulation Disorder from other disorders?

such as Bipolar, ADHD (may be comorbid), Oppositional Defiance Disorder (children), Intermittent Explosive Disorder.

A

its the level of chronicity that distinguishes this disorder from others with similar symptoms

16:05

28
Q

What aspect of the HPA axis is hypothesised to contribute to Depressive Disorders & Bipolar Disorder?

A

poorly regulated cortisol system 1:15:00

28
Q

What is important to note about the influence of genes in mood disorders?

A
  • they don’t cause disorders
  • they confer a vulnerability
  • sets stage for disorder in context of other factors

1:08:00

28
Q

What social aspect contributes to Depressive Disorders?

A

Stressors Lack of Support to deal with Stressor 1:17:00

28
Q

What bolsters the odds of successful treatment for Bipolar Disorder by 20%?

A

Combining psychotherapy with medication

  • bolsters odds of recovery
  • by up to 20% above either alone
29
Q

What happens in the amygdala during depression?

What is generally seen in other brain regions?

What are the behavioural outcomes?

A

Amygdala

  • increased activity
  • hyper-reactivity to emotional stimuli

Other regions

  • diminished activation
  • decreased volume in other regions
  • less activity in these regions involved in planning etc

Outcome

  • react with
    • increased emotion
    • less ability to plan

1:11:50

30
Q

What new lines of neurobiological research

have shed some light on what differentiates

Major Depressive DIsorder from Bipolar Disorder?

A

Manic Episode

  • Basal ganglia
  • particularly active
  • involved in reward reactions
  • differentiates Manic from MDD

Bipolar Disorder

  • Changes in neuronal membranes
  • influencing how readily they can be activated
  • not seen in MDD

1:12:50

z. z. PSY3032 Lectures - Abnormal Psychology (20 decks)

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