Chapter 8 - Depression Flashcards
(50 cards)
What are the different Depressive Disorders?
-Disruptive Mood Dysregulation Disorder (DMDD)
-Major Depressive Disorder (MDD)
-Persistent Depressive Disorder (Dysthymia)
-Premenstrual Dysphoric Disorder
What are the different Bipolar Disorders?
-Bipolar I Disorder
-Bipolar II Disorder
-Cyclothymic Disorder
How do we distinguish mood disorders from temporary emotional reactions?
-duration: mood pervasive across situations and time (weeks, months)
-impaired ability to function
-mood changes often occurs for no apparent reason or are extreme reactions not easily explained by what is happening in the person’s life
-cluster of additional signs and symptoms
What is the DSM-5 Criteria for MDD?
A: >= 5 of the following during a 2-week period and are present the majority of the time
-at least 1 of these: depressed mood or anhedonia (lack of pleasure)
-plus at least 4 of these: significant change in weight/appetite; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue/loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking/concentrating; recurrent thoughts of death, suicidal ideation with or w/out plan, or suicide attempt
B: Cause significant distress or impairment
C: Episode not attributable to substances or medical condition
D: Symptoms not better explained by another mental disorder
E: No history of manic episode or hypomanic episode
*Criteria A-C represents a major depressive episode
What are some MDD specifiers?
-severity: mild/moderate/severe
-in partial remission/in full remission
-single/recurrent episode
-with psychotic features: hallucinations or delusions
-with anxious distress: anxious symptoms
-with peripartum onset: onset during pregnancy or within 4 weeks of delivery
-with seasonal pattern: associated with changes in daylight as the seasons change
What is the recurrence of Depressive Episodes?
-each major depressive episode increases the risk of a subsequent episode:
1 episode - 50-60% will have another
2 episodes - 70% will have another
3 episodes - 90% will have another
-with each subsequent episode, the length of time to recurrence is shortened
What is Persistent Depressive Disorder (Dysthymia)?
-more chronic
-usually less severe symptoms, but not always
-depressed mood for at least 2 years
What are the DSM-5 criterias for Persistent Depressive Disorder (Dysthymia)?
A: Depressed mood for at least 2 years (most of the day, more days than not)
B: At least 2 of the following while depressed: poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; feelings of helplessness
C: During the 2 year period, the individual has never been without symptoms for more than 2 months
D: Criteria for major depressive disorder may be continuously present for 2 years
E: Never been a manic or hypomanic episode
F and G: Not explained by another mental or medical condition
H: Cause significant distress or impairment
What is the prevalence of Depressive Disorders?
-2nd leading cause of disability worldwide
-MDD: lifetime prevalence of 15-20%; typical onset late 20s
-PDD: lifetime prevalence 3-6% in Canada; typical onset late childhood/adolescence
-72% of individuals with MDD has comorbidity: 59% anxiety disorder, 24% substance use disorder, 30% impulse control disorder
What is Neurotransmitter Dysfunction (biological dimension)?
-low levels of Norepinephrine, Dopamine, and Serotonin
-antidepressant medications –> increase availability of NTs
What is Norepinephrine’s role?
-regulation of attention, arousal and concentration, dreaming, and moods; as a hormone, influences physiological reactions related to stress
What is Dopamine’s role?
-influences motivation and reward-seeking behaviours; regulates movement, emotional responses, attention, and planning
What is Serotonin’s role?
-inhibitory effects regulate temperature, mood, appetite, and sleep; reduced serotonin can increase impulsive behaviour and aggression
Does heritability play a role in MDD?
-concordance rates for MDD: DZ twins - 10%; MZ twins - 40%
-~35% variability in risk of developing MDD due to heritability
What is neuroendocrine dysregulation?
-dysregulation and overactivity of HPA axis
-overproduction of stress-related hormones appear to play an important role in depression
–people with depression have higher blood levels of cortisol
What are the brain changes linked to depression?
-depressed individuals have decreased brain activity and other brain changes
-decreased neuroplasticity and neurogenesis in the hippocampus
-structural differences in hippocampus
-functional differences - reduced activation in prefrontal cortex and increased reactivity in amygdala
How do circadian rhythm disturbances impact depression?
-circadian rhythms: internal biological rhythms maintained by melatonin
-sleep disturbances strongly linked to depression
-depression linked to disruptions (for those with or without seasonal patterns)
-irregularities in rapid eye movement (REM)
What do Behavioural Theories think causes depression?
-depression occurs when people receive insufficient social reinforcement
According to behavioural theories, when does the risk of depression increase?
-limited opportunities to engage in reinforcing activities
-there are few reinforcements available in the environment
-person’s behaviour/social skills result in limited reinforcement
What do Cognitive Theories think causes depression?
-depression is a disturbance in thinking rather than a disturbance in mood
What does Beck’s theory of depression focus on (cog theory)?
-self - negative self-schema
-world
-future
negative thinking patterns
What is the Response Styles Theory (Nolen-Hoeksema) (cog theory)?
-the way a person responds to a negative mood can have an impact on the severity and/or duration of the mood
What is rumination (cog theory)?
-focused attention on negative emotional state, thinking repeatedly about the causes and consequences
-co-rumination: constantly talking of problems or negative experiences with others
-increases depression risk, especially in females
What is Attributional Style and the 2 different types (cog theory)?
-characteristic way of explaining why a positive/negative event occurred
–negative attributional style = focus on causes that are internal, stable, and global
–positive attributional style = focus on causes that are external, unstable, and specific
