PSY240 4. Depression Flashcards

Question

Major Depressive Disorder

Answer 1

An “expectable response” to the death of a loved one • A “culturally sanctioned response” to the event • Certain symptoms are less common

Answer 2

Omitted from DSM-5, because: | – Removes implication that bereavement lasts

Answer 3

Removal in DSM-5 is Controversial! – Associated with lower risk of subsequent MDEs – Less associated with treatment-seeking – Less associated with substantial functional impairment – Associated with lower Neuroticism and guilt

Answer 4

* 8.2 – 12.2% lifetime prevalence (Canada) * 15 – 24 yrs old most likely to have a current MDE * More common in females (2:1) * > 50% have a comorbid condition

Answer 5

• Children

Answer 6

``` DSM-IV Mood Disorders Chapter  – DSM-5 Depressive Disorders Chapter – DSM-5 Bipolar and Related Disorders Chapter • Added: – Premenstrual dysphoric disorder added – Persistent depressive disorder added – Disruptive mood dysregulation disorder ```

Answer 7

5+ symptoms in the final week before the onset of menses, that improve within a few days of onset • Affective Symptoms – Marked affective lability – Marked irritability or anger – Marked depressed mood – Marked anxiety • At least one Cognitive/Physical symptom

Answer 8

Includes – DSM-IV Dysthymic disorder (3+symptoms, 2+ years) – Chronic major depressive disorder (5+symptoms) • Symptoms for 2+ years – No periods >2 month without symptoms

Answer 9

``` Severe temper outbursts – Out of proportion – Inconsistent with developmental level – 2-3 times/week • Mood is otherwise irritable/angry • 12+ months • Diagnosed between 6 – 18 yrs ```

Answer 10

``` Amygdala: • Associated with emotions • Activated in recall of emotional memories • Higher activity among depressed Thalamus: • Relay center for sensory information • Sensory input (pleasant & unpleasant feelings) Hippocampus: • Processing long term memory • Smaller in depressed people • Stress hormones may impair its growth ```

Answer 11

Hypothalamic-pituitary-adrenal (HPA) axis • Governs hormonal activities Cortisol: • Steroid hormone • Indexes HPA activation • Involved in stress responses Response to stress: • Hypothalamus releases corticotropin-releasing hormone (CRH) • Anterior pituitary releases adrenocorticotropic hormone (ACTH) • Adrenal cortex releases cortisol

Answer 12

``` Acetylcholine (ACh) • Memory, learning Serotonin (5-HT) • Sleep, appetite, mood Norepinephrine (NE) • Activity, motivation/reward Dopamine (DA) • Movement, motivation/reward Gamma-aminobutyric acid (GABA) • Inhibitory ```

Answer 13

``` Twin & Family Studies • Estimated heritability at 37% • 1st degree relatives at increased risk for depression – Early onset – Higher recurrence ```

Answer 14

Candidate Gene Studies • Serotonergic genes (e.g., SLC6A4; 5HTT) • Brain-derived neurotrophic factor (BDNF) gene

Answer 15

``` Stressful life events – Often precede onset of depression – Diathesis-stress model • Learned helplessness – Belief of having no control over stress  depression – Depressive attributional style • Internal, Stable, Global ```

Answer 16

``` Cognitive triad of depression: Self, World, & Future Early Experience Dysfunctional Beliefs Critical Incident(s) Beliefs Activated Negative Automatic Thoughts Symptoms of Depression ```

Answer 17

* Marital relations * Gender imbalances * Social support

Answer 18

``` Drug therapy / Antidepressants (ADM) – Tricyclics – Monoamine oxidase inhibitors – Selective serotonin reuptake inhibitors – “Atypicals” (e.g., Wellbutrin) • Electroconvulsive therapy (ECT) • Repetitive Transcranial Magnetic Stimulation (rTMS) • Light therapy ```

Answer 19

``` • Behavioural Therapy (BT) – Increase positive reinforcers and decrease aversive events – Teach new coping skills • Cognitive-behavioural Therapy (CBT) – Challenge distorted thinking – Teach more adaptive ways of thinking – Teach new behavioural skills ```

Answer 20

Interpersonal Therapy (IPT) – Focuses upon actual grief or loss – Interpersonal role disputes, role transitions – Interpersonal skills deficits • Psychodynamic Therapy (PT) – Gain insight on hostility and fears of abandonment – Facilitate change in self-concept and behaviours

Answer 21

Mindfulness meditation • Mindfulness-based cognitive therapy (Segal et al., 2002) – Group therapy – Increase awareness of thoughts and feelings – Thoughts and feelings are mental events, not reality – Reduces relapse in patients with recurrent depression

Answer 22

• IPT, CBT, and drug therapies seem to work well • ADM + psychotherapy for chronic depression • Emphasis on prevention, early interventions – Advantages of MBCT

Answer 23

* Mania and depressive symptoms * 0.6 - 4.4% of the population * Average age of onset is in the 20s * Males = Females

Answer 24

Elevated or irritable mood and increased activity level (DSM-5) +3 symptoms (4 if irritable mood) – ↑ activity level (work, socially, or sexually) – Talkative/rapid speech – Flight of ideas/racing thoughts – Less need for sleep – Inflated self-esteem – Distractibility – Excessive involvement in pleasurable activities

Answer 25

``` Mania • Symptoms last >1 week OR • Hospitalization required – Psychotic features  Bipolar I ```

Answer 26

``` Hypomania • Symptoms last > 4 days • No hospitalization • No psychotic features • Lesser severity  Bipolar II ```

Answer 27

* Hypomania * Depressive symptoms, but no MDE * Symptoms 2+ years

Answer 28

Biological • Genetic diathesis (85% concordance rate) – 8-10% first degree relatives (vs. 1% in population) • Low 5-HT or NE (in depressed phase) • High NE & DA (in manic phase) Psychological ??

Answer 29

Biological • Genetic diathesis (85% concordance rate) – 8-10% first degree relatives (vs. 1% in population) • Low 5-HT or NE (in depressed phase) • High NE & DA (in manic phase) Psychological ??

Answer 30

Pharmacotherapy: lithium, anticonvulsants, antipsychotics – May be used in combination with other drugs – Side effects • Psychological: Family-focused, psychoeducation, interpersonal therapy, CBT

PSY240 4. Depression Flashcards

(164 cards)