Flashcards in Unipolar depression Deck (67)
Changes from DSM-IV to DSM-V?
DSM-IV - there was one chapter for Mood Disorders
DSM-V - there is now a separate chapter for Bipolar Disorders
How many symptoms are needed for a major depressive episode?
5 or more (including 'depressed mood most of the day, nearly every day' and/or 'marked diminished interest in activities') in a 2 week period
What is the difference between DSM-IV and DSM-V in regards to MDD?
DSM-IV specifies that the symptoms must not be better accounted for by bereavement (allowed to feel like this for 2 months)
Why is DSM-IV's Dysthymia now called Persistent Depressive Disorder?
Research has suggested that Dysthymia is not really a different disorder
While depressed, the person with PDD must have 2 of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteen
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
What is the duration criterion of PDD?
Symptoms must have last 2 years, no more than 2 months of normal mood during those 2 years
DSM-5 Disruptive Mood Dysregulation Disorder is characterised by...
- childhood onset
- severe, recurrent temper outbursts that are grossly out of proportion in intensity or duration to situation or provocation
- at least 3 times a week
- 12 months duration
- child is persistently irritable or angry
How to treat Disruptive Mood Dysregulation Disorder?
Emotion regulation rather than drugs
Risk of developing another depressive episode increases by ___ after each episode
What are the different subtypes/specifiers of MD?
1. anxious distress
2. seasonal pattern (Seasonal Affective Disorder)
3. peripartum onset (Postnatal depression)
4. Atypical features (eg weight gain, oversleep, rejection sensitivity)
5. Psychotic features (hallucinations and delusions)
6. Melancholic features
Some research suggests that depression with ______ features is a very distinct subtype of depression, almost like a different disorder.
Parker (2000) suggests that depression should be categorised under 3 subtypes. What are they?
Melancholic, psychotic and non-melancholic
- assumes different symptoms, causation and treatment
What is melancholic depression characterised by?
Lack of reactivity / total loss of pleasure. Even something highly stimulating is unable to lift their mood.
Distinct quality of mood. (diff. to normal depression)
Mood worse in morning
Early morning awakening
Marked psychomotor agitation or retardation - feelings of heaviness
Melancholic and psychotic subtypes are seen as "_________ depression"
endogenous (biological) - more ass. with genetic loading compared to non-melancholic subtype which is more environmentally based
Melancholic and psychotic subtypes are best treated with _____ and don't respond to ______ as well as non-melancholic subtype
biological treatments, placebo pill
Lots of researchers argue that melancholic depression is not a separate type of depression but...
Just a more severe form of depression, not a different cause
Lifetime prevalence of MDD is around ___
One-year prevalence of MDD in Australia is around
Since the mid-20th century, more people have been diagnosed with depression and at an increasingly younger age. Why?
1. Increased speed of change/stress
2. Decreased social support/family support
3. Possible that it is more acceptable to report symptoms - less stigma, more education
5. Change of values? You have to be happy always etc
What is the gender ratio of diagnosis of MDD?
Twice as many woman are diagnosed with depression.
This imbalance emerges during late adolescence and evens out after 65
For MDD: Concordance rates are...
higher in identical twins than fraternal twins
Bipolar depression has a _____ genetic influence than unipolar depression and is ________ separately
Has been argued that individuals with depression have lower levels of .... (neurochemistry). Why is this aetiology controversial?
Dopamine, serotonin, noradrenaline.
No good evidence for how these lower levels lead to depression (the mechanism)
The absolute levels of dopamine, serotonin, noradrenaline are not important in determining unipolar depression but rather the...
sensitivity of the receptors to the neurotransmitters
Which brain structures are implicated in unipolar depression?
- remember it is correlation not causation
In addition to the functional abnormalities in brain structures, the _________ system (hormonal) is also implicated in depression
___________ in the ____ Axis is strongly related to depression
The HPA axis is involved in _________ response to _________
Individuals with depression tend to have an elevated stress response: that is,
they release too much cortisol, and take longer to switch off their stress response - cortisol keeps coming into the system
Therefore, (early) stress is highly implicated in the causation of depression even at the biological level