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Mood Disorders Flashcards

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1
Q

what are analogue experiments

A

to study something in a controlled environment
create clinical situations or sympotm manifestation in lab setting

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2
Q

fear conditioning

A

when induce a specific fear in a healthy subject - to understand physiology and techniques which help to unlearn fear

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3
Q

definition of mood

A

prolonged emotional state

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4
Q

definition of disorder

A

a gross deviation in mood from what is considered the normal range

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5
Q

which characteristics of mood disorders determine diagnosis

A

major depressive, manic, and hyponmanic episodes

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6
Q

major depressive disorder needs how many symptoms

A

5/9

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7
Q

what are the necessary features for depression diagnosis

A

present nearly everyday during same 2 week period
represents change from previous functioning
at least one symptoms is depressed mood or loss of interest/pleasure

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8
Q

symptoms of MDD

A
  • depressed mood
  • diminished interest/pleasure in almost all activities
  • weight/appetite change (weight loss/gain, increase/decrease in appetite)
  • sleep disturbance (insomnia, hypersomnia)
  • psychomotor agitation (fidgeting) or retardation (slow)
  • fatigue or loss of energy
  • feelings of worthlessness or excessive guilt
  • diminished ability to think/concentrate/indecisive
  • recurrent thoughts of death, suicidal ideation, suicide attempts/plans
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9
Q

important feature criteria for all disorders

A

must cause clinically significant distress/impairment in functioning
departure from normal state
episode is not attributable to effects of substance or other medical condition

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10
Q

clinical judgements which are not in diagnostic criteria

A

responses to significant loss may include sadness, rumination, insomnia, appetite

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11
Q

persistent depressive disorders (dysthymia) - necessary for diagnosis

A

depressed mood for most of the day, for more days than not, for at least 2 years (1 year for children and adolescents)

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12
Q

criteria for pDD

A
  • poor appetite or overeating
  • insomnia, or hypersomnia
  • low energy/fatigue
  • low self esteem
  • poor concentration or diffculty making decisions
  • feelings of hopelessness
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13
Q

how many symptoms of criteria needed for PDD

A

2 of 6

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14
Q

disruptive mood disregulation disorder

A

severe recurrent temper outbursts
persistent negative mood (anger, irritability) for at least 1 year before age 10

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15
Q

issues with diagnosis of DMDD

A

limited evidence base
poor reliability
issues with over diagnosis
only considers behavioural interventions
captures irritability but not mania

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16
Q

what was DMDD designed to reduce

A

diagnosis of bipolar disorder in children

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17
Q

premenstrual dysphoric disorder and treatment

A

mood symptoms in week before menses
hormonal treatments (SSRIs used for part of the month)

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18
Q

what is the most popular mental disorder

A

depression

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19
Q

sex differences in depression

A

females 2x more likely to get depression

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20
Q

reasons for sex differences in depression

A

stresses occur in adolescent different for sexes
female puberty more pronounced
social roles
body image
rate of reporting
victims of sexual abuse

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21
Q

age of onset of depression

A

late teens to early 20s

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22
Q

SES and depression

A

depression rates 3x higher in low SES

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23
Q

bipolar disorder description

A

distinct periods of abnormally and persistently elevated, expansive (expression of emotion, feelings of grandiosity and friendly or excuberant) or irritable mood

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24
Q

manic symptoms of bipolar disorder

A
  • increased self esteem; belief one has special powers
  • decreased need for sleep
  • unusual talkativeness
  • flight of ideas (racing thoughts)
  • distractibility
  • increase in goal directed activity / psychomotor agitation
  • excessive involvement in activities with high potential for severe consequences
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25
hypomania
a lesser form of mania - lasts less time, no psychosis, not significant impaired functioning
26
how many kinds of bipolar disorder
3
27
bipolar 1 disorder
at least 1 manic episode in life often severe MDD episodes but not required for diagnosis
28
bipolar 2 disorder
at least one MDD episode at least one hypomanic episode (no lifetime episode of mania)
29
cyclothymic disorder
for at least 2 years - numerous period of hypomanic symptoms that do not meet criteria for hypomania - numerous periods of depressive symptoms that do not meet criteria for MDD
30
lifetime prevalence of BP
~1%
31
how many cases of BP onset before 25 y/o
more than 50%
32
does BP have higher comorbidity and with which ones
~60% have 3 or more comorbidities substance use most common in BP (40-60%)
33
subtypes and specifiers for BP
seasonal patterns rapid cycling forms psychotic features mixed features - depression and mania at same time catatonia melancholic features - lack of pleasure in anything atypical features - over/under eating peripartum onset anxious distress
34
aetiology ?
study of causes of disorders
35
BP and heritability
2x more heritable
36
estimate of heritability of depression
37%
37
how do we get estimates of heritability
population studied twin studies
38
effect of stress on depression risk
more stress more risk
39
which neurotransmitters are implicated in aetiology of mood disorders
dopamine noradrenaline serotonin
40
what is the evidence for role of serotonin in disorders
drugs which improve disorder symptoms modulate the activity of serotonin
41
which brain structures are associated with depression
amgdala, striatum, hippocmapus, frontal cortex, ACC
42
what is the issue with brain structure aetiology
observations take place after incidence is identified and endured behaviours and emotion can impact the structure and function of brain cause and effect cannot be determined
43
amygdala is responsible for?
emotional experience and assigning emotional relevance to stimuli
44
findings about the amygdala
increased activity in response to negative stimuli abnormalities in responsibility of amygdala found in those with familial risk for depression
45
what is the striatum for
rewward processing and motivation
46
findings about striatum
reduced activity in ventral striatum may be linked to learning from reward and issues with motivation increased striatum activity in BP - play role in impulsive behaviours
47
what happens with HPA axis in prolonged stress states
increased blood pressure chronic msucle tensions neurotoxicity and neural atrophy disturbances in neurotransmitters
48
increased high cortisol levels risk?
MDD
49
cortisol responses in MDD and BP
consistent dysregulation in HPA axis
50
what does increased amygdala reactivity do
triggers HPA axis
51
why is stress good for the hippocampus
improves functionality
52
what happens when hippocampus is overactivated with stress
goes into poor functioning and loss of neurons
53
MDD patients and hippocampus
MDD have smaller hippocampal volumes
54
cognitive theories and assumption made? of aetiology
bad things happen, but what is important is how we think about them
55
what is the negative triad
person has negative view of self negative view of future negative view of world
56
what happens when we have negative schemas
influences how we evaluate information
57
when are schemas activated
when someone encounters as situation similar to the ones which caused the schema to form
58
when are schemas acquired
in childhood and exacerbated by childhood experiences
59
what is beck's theory of schemas
schemas activated by events which influence information processing - cognitive bias - MDD patients attend to negative informaiton more than positve, schema of world is confirmed and maintained
60
negative cognitive styles and MDD
negative cognitive styles elevate risk of developing MDD
61
what is hopelessness theory
idea that good things wont happen and we cannot change this
62
hopelessness theory and attribution
when something bad happens, we attribute a cause what we determine as cause is considered correct
63
hopelessness theory and therapy
to adjust cognitive styles around attributions
64
hopelessness and MDD
high levels of hopelessness 6x more likely to experience MDD episodes in future
65
major risk factor for mood disorders
childhood adversity
66
stress diathesis model
experience of seriosu life event before MDD begins
67
effect of stressful events
reduce resilience, problems more likely to occur
68
what is the first line of medication for MDD
antidepressants
69
SSRIs are
most prescribed increase level of serotonin available blocks reuptake
70
results of antidepressants
37% achieve remission with first antidepressant around 50% reduction in disorder 30% of people respond to placebo
71
medications for BP
mood stabilisers lithium antipsychotic medications anticonvulsant antidepressants
72
mood stabilsiers
medications for BP reducing manic symptoms
73
lithium
first line treatment for BP, 80% of BP cases experience mild benefits lowers excess noradrenaline in manic episodes and triggers serotonin in depressive episodes
74
antipsychotic medication
given during manic episodes
75
anticonvulsant medication
given for rapid cycling in BP
76
antidepressants for BP
given during depressive episodes
77
issues with lithium as BP medication
must be closely monitored as high levels can be toxic affects many bodily functions (weight gain, increased thirst, tremors, circulatory problems)
78
antidepressants in BP patients without lithium
can initiate manic episode
79
what is ECT
Electroconvulsive therapy v effective in treating severe depression
80
why is ECT controversial
used to be done without consent long side effects of memory loss, impairments in cognitive function
81
why is ECT used and response rate
effective for treatment resistant depression - reduces the suicide risk associated with severe depression 70% response rate
82
psycho-education
helping to understand the symptoms, nature and course of disorders etc
83
what is CBT
combo of cog and behavioural approaches
84
key components of CBT
- thoughts, feelings and behaviours are all interconnected and trap individuals in a cycle - reevaluates negative views or interpretations - breaks cycle, challenges cognitive beliefs and schemas, feelings of negativity - develop strategies to think about and deal with problem in more positive way
85
psychodynamic therapy
focuses on thought pattern existing today rather than from the past
86
what influences how people view world in a biassed way, and how to overcome
negative automatic thoughts - understand link between thoughts and emotions, estimate evidence for and against NAT, challenge NAT, and generate more balanced alternative thoughts
87
combination of psych therapy and medication for MDD?
best approach improves odd of recovery by 10-20%
88
why are antidepressants good
offer relief from symptoms quicker
89
why is therapy good
takes longer but imparts skills they can use after treatment is over - preventative
90
psychotherapy treatments of BP - methods
concurrent psychosocial and psychotherapy address associated social and psychological problems
91
psychotherapy for BP - what does it do
improves ability to detect mania encourages acceptance of illness improves adherence to drug regimen enhance ability to cope with stressors fosters daily routines of sleep improves communications with family eliminates drug or alcohol misuse
92
treatment for disruptive mood dysregulation disorder and what does it do
CBT for anger and disruptive behaviour - relabels perceptions that lead to outbursts, tolerate frustration, coping skills dialectical behaviour therapy -skills to regulate emotions, targets irritability
93
medications for disruptive mood dysregulation disorder
antidepressants for irritability and mood stimulations for irritability atypical antipsychotic medications for aggression)

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