Depressive Disorders

Question 1

What are the 5 depressive illnesses?
What are the aspect differences?

Answer 1

1. Major Depressive Disorder
2. Persistent Depressive Disorder (aka Dysthimia)
3. Premenstrual Dysphoric Disorder
4. Substance/Medication-Induced Depressive Disorder
5. Disruptive Mood Disregulation Disorder
   *for children younger than 12

will differ by duration, timing, or presumed etiology (causes)

Question 2

What are the common features of depressive disorders?

Answer 2

presence of sad, empty, or irritable mood
irritable can be depressive episode

Question 3

What are depressive disorder features accompanied by?
What are some change examples?

Answer 3

can be accompanied by somatic and cognitive changes that significantly affect the capacity to function

Somatic changes: appetite, sleep, chronic pain
Cognitive changes: feeling hopeless

Question 4

What are the differences between Female and Male cognitive changes?

Answer 4

Females feel more sadness; may loose motivation
Males feel more numbness

Question 5

What is needed for criteria A?

Answer 5

5 or more of the 9 symptoms must have been present during the same 2 weeks with a change from previous functioning
one of the symptoms HAS TO BE depressed mood or loss of interest/pleasure

Question 6

What are the 9 symptoms?

Answer 6

1. depressed mood most of the day/almost every day
2. markedly diminished interest or pleasure; numbness
3. significant weight loss >5% in am month (NOT DIETING)/ increase or decrease of appetite
4. insomnia or hypersomnia
5. psychomotor agitation or retardation; immobility
6. fatigue or loss of energy
7. feeling worthless or excessive guilt
8. can’t concentrate/indecisiveness
   ex: because of rumination
9. recurring thoughts of death, suicide ideation w/o a plan, suicide attempt with a specific plan

Question 7

What is needed for criteria B?

Answer 7

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Question 8

What is the prevalence of MDD in US adults?
What is the lifetime prevalence M vs. F?
What is the early adolescence prevalence difference in F v. M?

Answer 8

1. 12 months; 7%
2. M - 1 in 6; F 1 in 4
3. females experience MDD 1.5x’s - 3x’s more

Question 9

Which somatic symptoms were found in American and Japanese depressed patients?

Answer 9

1. headache
2. fatigue
3. neck pain
4. abdominal symptoms
5. loss of appetite
6. sleep issues

Question 10

Which medical illnesses are linked to depression?

Answer 10

1. diabetes
2. cancer
3. chronic pain
4. heart disease
5. autoimmune disease
6. IBS
7. hypothyroidism
8. COPD

Question 11

Why is there an overlap between brain regions related to depression and pain?

Answer 11

the nociceptive pathway for psychological pain includes some of the same brain structures from the affective-emotional pathway for physical pain

Question 12

What are the overlapping brain regions between chronic pain and depression?

Answer 12

1. anterior insula
2. anterior cingulate cortex
3. prefrontal cortex
4. thalamus
5. Additional research: amygdala and hippocampus

Question 13

What are common neurotransmitters in chronic pain and depression?

Answer 13

serotonin
norepinephrine
glutamate
GABA

Question 14

What is prescribed that has at least a moderate analgesic effect for pain conditions?

Answer 14

antidepressants

Question 15

Which comes first, chronic pain or depression?
How can it be treated?

Answer 15

1. chronic pain; depression is a response to the consequences of living with constant
   pain
2. treatment: teach the idea to accept the pain and live a life

Question 16

How does bereavement vary across races/ethnicities?

Answer 16

duration & expression

Question 17

What depressive symptoms are present in bereavement?
What needs to be considered an exception within “normal” limits of bereavement?

Answer 17

excessive guilt
persistent thought of death
functional impairment
hallucinations

hearing or seeing someone could be normal

Question 18

_____ is the __ leading cause of death in the US.

Answer 18

Suicide, 8th

Question 19

Suicide is highly prevalent in what two races?
& in what age group?
What are the gender differences?
What are the 2 indices of suicidal behavior?

Answer 19

1. white & native american
2. youth
3. males are more likely to complete; females are more likely to attempt
4. suicidal attempts and ideations

Question 20

What are 8 risk factors of suicide?

Answer 20

Suicidal thoughts with intent
Suicide in the Family
Low Serotonin/Norepinephrine Levels
Evidence of a Preexisting Psychological Disorder
Alcohol Use and Abuse
Past Suicidal Behavior
Experiencing of a Shameful/Humiliating Stressor
Publicity About Suicide and Media Coverage

Question 21

What are the genetic influences of suicide in twin studies?

Answer 21

concordance rates are high in monozygotic twins (identical)
sever cases have stronger genetic contribution
heritability is higher for females

Question 22

Which two neurotransmitters have a neurobiological influence in depression?
What increases in the endorcine system?
What disruption has a strong relationship to depression?

Answer 22

1. Low serotonin & norepinephrine
2. cortisol
3. sleep; disrupted circadian rhythms

Question 23

What increases and decreases because of low serotonin?
What decreases because of low norepinephrine?
What is presented by a patient in a depressive mood with altered 5HT & NE?

Answer 23

5HT: low sex drive and appetite, high aggression
NE: low concentration, interest, motivation
Depressed Mood: anxiety, irritability, slow/blocked thought process, vague aches and pain

Question 24

According to Beck what is psychological influence of stress in mood disorders?

Answer 24

stress can start cognitive and biological processes that increase risk of a mood disorder

Question 25

According to Kessler, what are the 2 best predictors of an onset of depression?

Answer 25

1. major life events: loss of work, loved one, finances
2. social rejection

Question 26

Stress can induce ________ in the _________.

Answer 26

inflammation, immune system

Question 27

What are cytokines?

Answer 27

Cytokines – proteins of the inflammatory response to stress; can cause more damage than the host pathogen itself

Question 28

What are the 8 sickness behaviors induced by cytokines?

Answer 28

Anhendonia; anticipated loss of reward in pleasure
Anorexia
Hypersomnia; sleep too much
Hyperalgisias; sensitivity to pain/extreme response to pain
Malaise; feeling of discomfort, illness, or lack of well-being
Poor concentration
Social withdrawal
Weakness

Question 29

What theory states: “lack of perceived control over life events”?

Answer 29

Learned Helplessness Theory of Depression

Question 30

What are the three domains of Depressive Attributional Style?
What do they sum up to?

Answer 30

Internal attributions
Stable Attributions
Global Attribution

= Hopelessness

Question 31

What are internal attributions?

Answer 31

believing all bad outcomes are your fault
“I failed because I am no good”

Question 32

What are stable attributions?

Answer 32

believe all future bad outcomes will be your fault
“I will always fail”

Question 33

What is global attribution?

Answer 33

believing they fail in many life activities
“I fail at everything”

Question 34

What is Aaron T. Beck’s cognitive Theory of Depression?

Answer 34

Depressed persons engage in cognitive errors
A tendency to interpret life events negatively

Question 35

What is Beck’s depressive cognitive triad?

Answer 35

think negatively about yourself, the future, and the world