Mood Disorders

Question 1

Years Lost Due to disability. Where does depression sit?

Answer 1

1990: It was first
2020: It will be (is) second.

Question 2

Disruptive Mood Dysregulation Disorder

Answer 2

Introduced to stop kids getting diagnosed with Bipolar disorder. Based on irritable mood (without elevated mood).

Question 3

If someone has never had depressive episodes (only manic), can they receive a diagnosis of bipolar?

Answer 3

Yes!

Question 4

How much time constitutes a “depressive episode”?

Answer 4

2 weeks.

Question 5

Anhedonic depression (opposed to low mood) more common in…

Answer 5

men.

Question 6

Depression prevalence in children:

Answer 6

2%

Question 7

Depression prevalence in adolescents:

Answer 7

1 in 10 to 1 in 4 experienced by end of adolescence

Question 8

Depression prevalence in adulthood:

Answer 8

Lifetime 17%

Question 9

Men:Women

Answer 9

1:2 (twice as many women)

Question 10

Average duration of MDD:

Answer 10

7 to 9 months 60-70% improve within 3 months

Question 11

Risk indicators?

Answer 11

Adolescent onset and suicidality

Question 12

average number of episodes?

Answer 12

5-6

Question 13

Depression diagnosis in elderly is underdiagnosed?

Answer 13

symptoms often masked by other ailments

Question 14

Why do women suffer depression more?

Answer 14

Women internalise, men externalise (alcoholism), more exposed to risk factors (demostic violence, poverty), societal burden on women increasing

Question 15

Bipolar I lifetime prevalence

Answer 15

1.6%

Question 16

Bipolar II lifetime prevalence

Answer 16

2%

Question 17

Mean age of onset of bipolar

Answer 17

21 yoa

Question 18

M:F ratio of bipolar I

Answer 18

1:1

Question 19

Depression to mania ratio bipolar I

Answer 19

3:1

Question 20

M:F ratio of bipolar II

Answer 20

more common in women

Question 21

Depression to mania ratio bipolar II

Answer 21

50:50

Question 22

How many episodes per year for bipolar I?

Answer 22

0.4-0.7 episodes per year

Question 23

Biological factors for depression?

Answer 23

Twin concordance rate for twins is almost 50%

Fraternal twin - 20%

Question 24

Does having a depressive twin raise likelihood of having bipolar yourself?

Answer 24

No. No increased risk of bipolar from genetic endowment.

Question 25

Does having a bipolar twin raise likelihood of having depression?

Answer 25

Yes. Bipolar genetic endowment increases risk of depression.

Question 26

Neurochemical factors...

Answer 26

Norepinephrine - depression and mania Serotonin - in depression (regulates other neurotransmitters) Dopamine - leads to depression, increase mania Lithium use suggests Norapinephrine involvement

Question 27

Endocrine system - "Stress hypothesis"

Answer 27

- Overactivation HPA axis - Neurohormones - Elevated cortisol - Supported hippocampal neurogenisis

Question 28

Psychological factors focus on...

Answer 28

meaning of events (cognitive approach)

Question 29

For what was CBT developed to treat?

Answer 29

Depression.

Question 30

What did Seligman do?

Answer 30

learned helplessness theory - people make attributions or explanations for events

Question 31

Beck?

Answer 31

shit covered glasses - "everything sucks" - these cognitions are reliably associated with depression. Beck thinks depressed state is due to these cognitions.

Question 32

Who invented CBT?

Answer 32

Beck!

Question 33

Negative triad?

Answer 33

Self - defective, deprived, inadequate - "I am useless" World - demanding, presenting hurdles - "Nothing ever goes right for me" Future - anticipates difficulties and struggles will continue - expects hardship, frustration, deprivation - "It will always be like this"

Question 34

Course of CBT

Answer 34

10-20 sessions - time limited and goal directed

Question 35

Behavioural aspect of CBT

Answer 35

get person activated and doing activities if reduced - scheduling activities - increase positive events that give pleasure and/or achievement

Question 36

Cognitive aspect of CBT

Answer 36

- identify unhelpful patterns of thinking - identify characteristic unhelpful styles, substitute more adaptive thoughts - correct negative cognitive schemas - underlying beliefs that drive thoughts in many life situations

Question 37

What is a genogram?

Answer 37

graphic representation of family tree that displays detailed data on relationships among individuals.

Question 38

How does CBT work?

Answer 38

- challenges depressive cognitions such as being ineffectual or unable to gain satisfaction from life - disconfirms depressive distortions through pleasurable and satisfying activities - focuses on activity assessment and increasing mastering and pleasure.

Question 39

What is Socratic questioning?

Answer 39

graded series of questioning to facilitate independent thinking -progressive series asked to shape client's thought processes