Mood Disorders

Question 1

DSM5 4 mood disorders

Answer 1

disruptive mood dysregulation disorder
major depressive disorder
persistent depressive disorder (dysthymia)
premenstrual dysphoric disorder

Question 2

DSM5 bipolar and related disorders

Answer 2

bipolar I
bipolar II
cyclothymic
moved into their own category away from depression to refelct differences in symptoms, family history and genetics

Question 3

disruptive mood dysregulation disorder overview

Answer 3

aged 6-18
seen in at least 2 settings for 12 months
more than or equal to 3 temper outbursts a week
persistent irritable mood
severe, recurrent temper outbursts
inconsistent with developmental level

Question 4

overview of major depression

Answer 4

depressed mood
anhedonia - inability to experience pleasure (don’t need both anhedonia and depressed mood)
cognitive symptoms - guilt, suicidal ideation, attention and memory problems etc
vegetative symptoms - bio (appetite, sleep, sex, energy)
2 weeks of symptoms - variable duration 3-12 months on avergae
recurrence is most common

Question 5

dysthymia overview

Answer 5

depressed mood for at least 2 weeks
may meet criteria for major depressive disorder (new)
chronic
base level = bit depressed
late onset - early 20s
early onset - pre 21, poorer prognosis

Question 6

premenstrual dysphoric disorder overview and defining features

Answer 6

5 or more symptoms:
lability (cry or nager for no reason), irratibility, depressed mood, anxiety / tension
loss of interest, concentration, lethargy, appetite, sleep, sense of dyscontrol (can’t deal with demands placed on you), physical symptoms
for most cycles in the past year

Question 7

bipolar 1 overview and defining features

Answer 7

full manic episodes
major depressive episodes (not needed for diagnosis but gonna happen in pretty much every case)
hypomanic episodes are common

Question 8

facts and stats bipolar I

Answer 8

18 yo = average age of onset

chronic

Question 9

bipolar II overview and defining features

Answer 9

hypomainc episodes and major depression requried

Question 10

facts and stats bipolar II

Answer 10

average age of onset is 22
longer severe depression than bipolar I
chronic

Question 11

cyclothymic disorder overview and defining features

Answer 11

hypomainc and depressive symptoms

pattern must last at least 2 years

Question 12

facts and stats cyclothymic dis

Answer 12

high risk of developing bipolar I or II
equal gender distribtuion
average age of onset = early adolescence

Question 13

major depression mnemonic and what it all stands for

Answer 13

SIGECAPS
Sleep
Interests
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicide

Question 14

difference between full mania and hypomania

Answer 14

hypomaina = no sleep problems or risky behaviour

eg hypomaina = pressured speech, madly peppy

Question 15

suicide risk is higher in

Answer 15

bipolar than depression as risky behaviour / impulsivity

Question 16

all depressed people are…

Answer 16

anxious but not all anxious people are depressed

Question 17

8 subtypes of mood disorders and explain where needed

Answer 17

anxious distress
mixed features
melancholic features
atypical features - no low appetite, too little sleep etc
pscyhotic features - only during episodesl consistent with mood
catatonic features - can’t move limbs, stay in weird position
postpartum features - post child birth, bio and hormones. more than just stressed and tired as new baby
seasonal onset (SAD) - treated by light exposure

Question 18

mood disorders sex differences

Answer 18

MDD 2(even3):1 female:male
bipolar 1:1

Question 19

genetic influences of mood disorders

Answer 19

strong familial inheritance for both depression and bipolar
serotnin transporter gene 5HTT = a candidate
depression in MDD and bipolar = same genetics
mania = separate genetics

Question 20

serotonin transporter gene vulnerablity explained

Answer 20

ss allelle and 4 major life stressors = now at risk
mice with altered 5HTT = susceptible to stress
macaques with 5HTT s gene susceptible to stress and show lower serotonin levels
humans with 5HTT s show increased amygdala activation to fearful stimuli

Question 21

neurobio influences on mood disorders

Answer 21

neurotransmitter systems = serotonin
endocrine system
sleep and circadian rhythms as sleep disturbances = a hallmark (melatonin can regulate sleep patterns)

Question 22

serotonin levels explained

Answer 22

normal = at peace
low = aggression, impulsivity
regulatory role - modulates other neurotransmitters (norepinephrine, dopamine)

Question 23

what is the permissive hypothesis

Answer 23

serotonin allows dysregulation of other neurotransmitters

treating serotonin imbalance brings down the others

Question 24

norepinephrine is for

Answer 24

excitatory
role in vegetive symptoms of depression
new SSRIs treat this too

Question 25

explain the endocrine system in mood disorders

Answer 25

cortisol (fight or flight) and dexamethansane (supresses cortisol) supression test (DST) isn't a diagnostic test

Question 26

learned helplessness animal research

Answer 26

dogs learn to avoid shock by jumping a barrier dogs who previously cannot control shock do not learn to avoid shock instead dogs become helpless / depressed looking

Question 27

learned helplessness theory of depression (seligman)

Answer 27

related to a lack of perceived control over life events 3 depressed attributional styles -internal -stable -global all 3 domains contribute to a sense of hopelessness

Question 28

internal attributions

Answer 28

negative outcomes are one's own fault

Question 29

stable attributions

Answer 29

believing future negative outcomes will be ones own fault - pessimism

Question 30

global attribution

Answer 30

believing negative events will disrupt many life activites

Question 31

explain Beck's cognitive triad

Answer 31

negative cognition about self world future

Question 32

Beck background

Answer 32

``` psychoanalytical when his patients free associating noticed weird cognitive leaps from a got a B in a class to gonna fail, dopr out, be homeless and die ```

Question 33

Beck's cognitive model of depression

Answer 33

``` progresses down this list early experience formation of depressogenic schemas criticl incidents schemas activated negative automatic thoughts (NATs) and symptoms (behavioural, cognitive, motivational, somatic, affective) in a cycle ```

Question 34

depressive cognitions according to Beck

Answer 34

negative cognitive triad (pessimistic views of the self, world and future) depressongenic (negative) schema - triggered by negative life events cognitive biases (systemtic logical errors) = depression

Question 35

7 cognitive biases in Beck's theory (named)

Answer 35

``` arbitrary inference selective abstraction overgeneralizatoin magnification and minimization personalization absolutistic dichotomous thinking should and must statements ```

Question 36

Beck's cognitive biases what is? | - arbitrary inference

Answer 36

prof must think i am stupid because i got a d

Question 37

Beck's cognitive biases what is? | - selective abstraction

Answer 37

i did poorly in test because i am stupid

Question 38

Beck's cognitive biases what is? | - overgeneralization

Answer 38

i got a d on the test, i am going to flunk out of school

Question 39

Beck's cognitive biases what is? | - magnification and minimization

Answer 39

that a was a fluke

Question 40

Beck's cognitive biases what is? | - personlization

Answer 40

prof didn't call on me - he must think i am dumb

Question 41

Beck's cognitive biases what is? | - absolutistic dichotomous thinking

Answer 41

if i don't get an a i am a loser

Question 42

Beck's cognitive biases what is? | - should and must statements

Answer 42

i have to get the highest grades

Question 43

integrative theory of mood disorders

Answer 43

shared bio vulnerability = overreactive neurobio response to stress exposure to stress - stress activates hormones that affect neurotransmitter systems -stress turns on certain genes, affects circadian rhythms, awakens dormant psych vulnerabilities, contributes to a sense of uncontrolability, fosters a sense of helplessness and hopelessness social and interpersonal support are moderators

Question 44

name the 4 drug classes used to treat mood disorders

Answer 44

tricylic MAO-I SSRIs lithium - bipolar / mania

Question 45

tricyclic meds

Answer 45

widely used block the re-uptake of norepinphrine and other neurotransmitters takes 2 - 8 weeks for therapeutic effects to be known negative side effects are common and start straight away so before getting any benefit are getting side effects may be lethal in excessive doses

Question 46

MAO-I

Answer 46

monoamine oxidase inhibitors blocks monoamine oxidase - an enzyme that breaks down serotonin / neuropinephrine MAO inhibitors are slightly more effective than tricyclics but must avoid foods contianing tyramine (beer, ref wine, cheese) also drug interactions with loads of drugs

Question 47

SSRIs

Answer 47

selective serotonin re-uptake inhibitors prozac = most popular pose no unique risk of suicide of or violence despite media - was an illusionary correlation negative symptoms are common but temporary -decreased sexual arousal / functioning -jittery -sleep disturbances no better than placebo for mild depression

Question 48

lithium

Answer 48

is a common salt with small amounts found in our water primary choice in bipolar treats mania - so also often need an anti-depressant too can have severe side effects = must monitor dose carefully unclear why it works common alternative = depakote = anti-seizure, mood stabilizer bipolar = must use meds. psych then can be used to but must be medicated

Question 49

ECT

Answer 49

effective in severe cases of depression brief electrical current to the brain resulting in temporary seizure 6-10 out patient treatments required side effects = few but include short term memory loss uncertainty why it works and relapse is common now we can use just unipolar (right side) placement instead of bilateral still some confusion 24hr after but much better

Question 50

pscyhosocial treatments

Answer 50

cognitive therapy -adresses errors in cognitive therapy -also includes behavioural components interpersonaly psychotherapy -focuese on problematic interpersonal relationships -also teach social skills / skills to build social network outcomes with pscyh are comparable to medication alot of trial and error carried about by therapist - need a large toolbox

Question 51

suicide facts and stats

Answer 51

11th biggest killer in the US white, native american phenomena rates are increasing, particulalry in the young gender = males are moe successful at comitting suicide (more violent methods), females attemot suicide more often

Question 52

risk factors in suicide

Answer 52

in the family low serotonin psych disorder alcohol use and abus past suicidal behaviour increases subsequent risk experiences of shameful/ humiliating stressor increases risk publicity about suicide and media coverage increases risk

Question 53

what to do as a therapist about suicide

Answer 53

research shows threats of suicide should be taken seriously do not be afradi of discussint he topic - better to talk than not becuase worried about triggering it get assisstance - don't accept responisibliity consider hospitalization