Depression, Self-Harm & Suicide

Question 1

What are the 3 types of depression?

Answer 1

1. bipolar (manic) depression
2. unipolar depression
3. dysthymia

Question 2

What is bipolar depression?

What characterises it?

Answer 2

1. Excessive elation, irritability, talkativeness
2. inflated self-esteem

This is followed by a period of depression

Question 3

What characterises unipolar depression?

Answer 3

There is no mania

Question 4

What is dysthymia?

Answer 4

A persistent low grade mood

Question 5

What is the difference between depression and not being happy?

Answer 5

Everyone goes through periods of not being happy - a reason can usually be identified

Depression is an illness and the sufferer has relatively little control over it

Question 6

What are the 5 questions that should be used in diagnosing depression?

Answer 6

Is the depression:

1. an illness or normal unhappiness?
2. secondary to a physical illness or alcohol/drugs?
3. presenting with physical symptoms?
4. co-occurring with anxiety?
5. placing person at risk of suicide?

Question 7

What are the 3 cores features of depression?

Answer 7

1. pervasive low mood
2. anhedonia (loss of interest and enjoyment)
3. reduced energy and diminished activity

Question 8

What is meant by a pervasive low mood?

Answer 8

A constant low mood that does not recede

Question 9

What are examples of anhedonia?

Answer 9

People losing interest in things that they used to enjoy

Examples of behaviours include people stopping going out and engaging in social activities

Question 10

What are the 2 main questions that can diagnose 85-90% of people with depression?

Answer 10

1. Have you been low in spirits?

2. Have you been able to enjoy the things you usually enjoy? (anhedonia)

Question 11

What is important to consider when asking screening questions for depression?

Answer 11

Context and history

Someone may answer yes to both questions, but may have had a recent bereavement in the family

Question 12

What is meant by the biological basis for depression?

Answer 12

Depression is associated with natural biological change

e.g. childbirth, menstrual cycle

Question 13

What are drug therapies used for depression?

Answer 13

1. Monoamine oxidase inhibitors (MAOIs)
2. Tricyclic antidepressants
3. SSRIs

Question 14

What are the 3 physical treatments for depression?

Answer 14

1. drug therapy
2. physical activity/exercise
3. electro-convulsive therapy (ECT)

Question 15

When is physical activity/exercise used as treatment for depression and why?

Answer 15

Mild depression

It is as effective as antidepressants or CBT

Question 16

When is electro-convulsive therapy used as a treatment for depression?

Answer 16

it is only used in intractable or psychotic depression

ECT acts as an end-point treatment for patients who have failed to respond to other treatments

Question 17

What theory is the basis for Cognitive Behavioural Therapy?

Answer 17

Beck’s cognitive theory of depression

Question 18

How do physical and psychological treatments for depression interact?

Answer 18

they work alongside each other

Drugs tend to relieve some of the more severe side effects, allowing people to engage in psychological treatment

Question 19

What is meant by the cognitive triad in Beck’s cognitive theory of depression?

Answer 19

1. negative view of self
2. negative view of experience
3. negative view of future

These 3 components together produce depression

Question 20

What are the errors in logic suggested by Beck’s cognitive theory of depression?

Answer 20

1. overgeneralisation

failing in one thing means you are useless at everything

2. magnification and minimisation

this is making disasters and failure to take praise

3. personalisation

this is taking all the blame

Question 21

What is involved in cognitive therapy?

Answer 21

It is a talking therapy that involves 6 - 20 sessions

It is as good as antidepressants in mild to moderate depression

Question 22

What are the 2 main cognitive therapy techniques?

Answer 22

1. reality testing automatic thoughts

(setting up situations in which people can re-learn what they predict of the future)

2. changing depressogenic assumptions

Question 23

What is an example of a depressogenic assumption?

Answer 23

In order to be happy, I have to be successful in everything I do

Question 24

What are the 4 terms that are used to refer to the same collection of self-harm behaviours?

Answer 24

1. deliberate self-harm
2. self-harm
3. parasuicide
4. attempted suicide

Question 25

What are the two main types of self-harm?

Answer 25

1. self-poisoning | 2. self-injury

Question 26

What is the definition of self-harm?

Answer 26

Intentional self-poisoning or self-injury, irrespective of motivation

Question 27

What is involved in self-poisoning?

Answer 27

The use of: 1. prescribed or over-the-counter drugs 2. recreational drugs 3. non-ingestible substances

Question 28

What are examples of self-injury?

Answer 28

1. self-cutting 2. jumping from a height 3. attempted hanging 4. swallowing foreign bodies 5. self-burning

Question 29

What are the gender differences in self-harm?

Answer 29

It is slightly more common in women up to the age of 20 After this age, it is no more common in women than in men

Question 30

What are the 8 motivations for self-harm?

Answer 30

1. relief from state of mind 2. escape from impossible situation 3. show how much you love someone 4. show somebody how you feel 5. find out if someone loves you 6. seek help 7. frighten someone/make them sorry 8. influence someone

Question 31

How is self harm characterised by: i. age ii. males and females iii. methods iv. link with mental illness v. rates

Answer 31

i. it reduces with age ii. it is equally common in males and females iii. cutting/poisoning iv. weak link with mental illness v. rates are rising

Question 32

How is suicide characterised by: i. age ii. males and females iii. methods iv. link with mental illness v. rates

Answer 32

i, increases with age ii. more common in males iii. violent methods iv. strong link to mental illness v. rates are falling

Question 33

What are the similarities between self harm and suicide?

Answer 33

1. they are increasing in young men 2. they are associated with alcohol misuse 3. they occur in the same people

Question 34

What are the 5 individual influences on suicide?

Answer 34

1. loneliness and loss 2. history of self-harm 3. substance misuse - especially alcohol 4. presence of a mental disorder 5. physical illness

Question 35

What is meant by modelling as a social influence on suicide?

Answer 35

Suicide contagion There is guidance on how the media should report suicide e.g. not giving too much detail as you do not want someone copying the method

Question 36

What is meant by the availability of methods as a social influence on suicide?

Answer 36

Reducing the pack size of paracetamol has reduced the numbers of suicides