EXAM 2 ABNORMAL PSYCH CHAPTER 7
Women account for __________ cases of major depressive disorder
7/10
Mood disorders may be misdiagnosed as ______
ADHD
Disruptive Mood Dysregulation Disorder
a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood
The risk of depressive disorders increases in
adolescences and young adulthood.
What is a more characteristic of major depressive episodes than reports of sadness or distress?
anhedonia (loss of energy and inability to engage in pleasurable activities or have any "fun")
Stable
believing future negative outcomes will be one's fault
Global
believing negative events will disrupt many life activities
Integrative Theory
biological and psychological vulnerabilities interact with stress life events to cause depression.
Last week, as he does about every 3 months, Ryan went out with his friends, buying rounds of drinks, socializing until early morning, and feeling on top of the world. Today Ryan will not even get out of bed to go to work, see his friends, or even turn on the lights.
bipolar I
What is a chronic version of bipolar disorder?
cyclothymic disorder
According to the learned helplessness theory of depression, people become _____________ depressed when they believe they have no control over the stress in their lives.
depressed
Severe mood disorders have a strong _______ contribution.
genetic
___________ dissatisfaction is strongly related to depression.
marital
What is the difference between bipolar I and II?
the absence of manic episodes in Bipolar II
Complicated grief seems to be associated with the activation of the
dopamine neurotransmitter system
Eusebio is always down and a bit blue, but occasionally he becomes so depressed that nothing pleases him.
double depression
What are the negative side effects of trycyclic antidepressants that are very common?
drowsiness and weight gain
Persistent depressive disorder was previously known as
dysthymia
A number of twin studies have suggested that mood disorders are
heritable
The risk of having a mood disorder is _________ if relative has a mood disorder.
higher
Women have __________ rates of anxiety disorders.
higher
Individuals experiencing heightened levels of stress hormones over a long period undergo some shrinkage of a brain structure called
hippocampus
In order to be diagnosed with Bipolar II, you need to have had a __________ episode.
hypomanic
What is the most popular SSRI?
Fluoxetine (Prozac)
What medication can pose some risk of suicide particularly in teenagers?
SSRIs
Manic episodes alone may be more frequent in
adolescents
What is the disadvantage of PMDD?
pathologizes (treat abnormally) an experience many consider to be normal
What are the Unipolar Depressive Disorders?
- Major depressive disorder - Persistent Depressive Disorder (dysthymia) - Premenstrual Dysphoric Disorder - Disruptive Mood Dysregulation Disorder
What are the two newly added unipolar depressive disorders to the DSM-5?
- Premenstrual Dysphoric Disorder - Disruptive Mood Dysregulation Disorder
What some risk factors of suicide?
- Suicide in the family - Low serotonin levels - Preexisting psychological disorder - Alcohol use and abuse - Stressful life event, especially humiliation - Past suicidal behavior - Plan and access to lethal methods
What are at least 4 additional physical or cognitive symptoms shown in patients with major depressive episodes?
- indecisiveness - feelings of worthlessness - fatigue - appetite change - restlessness or feeling slowed down - sleep disturbance
What is the difference between persistent depressive disorder or "PDD" (dysthymia) and major depressive disorder or "MDD"?
- the number of symptoms required for PDD are less. - mostly in its chronicity - PDD is considered more severe since patients present with higher rates of comorbidity with other mental disorders, are less responsive to treatment, and show a slower rate of improvement over time.
All mood disorders share:
-Gross deviations in mood -Common biological and psychological vulnerability
In maniac episodes, the individual has an elevated expansive mood for at least _______ week/s.
1
To be diagnosed with major depressive disorder, at least __________ major depressive episode.
1 an individual within a 2-week period had to have reported 5 of the symptoms for a major depressive episode.
In order for an individual to be diagnosed with bipolar II, criteria have been met for at least ______ hypomanic episode and at least ______ major depressive episode.
1 there has never been a manic episode
For kids to be diagnosed with persistent depressive disorder, they need to have a _______ period of this low grade version of depression.
1-year
In addition to rating severity of the episode as mild, moderate, or severe, clinicians use 8 basic specifiers to describe depressive disorders:
1. with psychotic features 2. with anxious distress (mild to severe) 3. with mixed features 4. with melancholic features 5. with atypical features 6. with catatonic features 7. with peripartum onset 8. with seasonal pattern
What percentage of college students consider suicide in a given year?
12%
A major depressive episode can last most of the day, nearly everyday, for at least ________ weeks.
2
People with cyclothymic disorder is ________ years for adults and ______ year for children.
2;1
The duration of an untreated manic episode
3-4 months
____________ can show depressive symptoms
3-month-olds
A hypomanic episode will last at least _____ days
4
What is the duration of a major depressive episode if it is left untreated?
4-9 months
In order to be diagnosed with PMDD, at least ________ symptoms must be present final week before the onset of menses, improve days after onset, and minimal/absent in week post menses.
5
In terms of suicide prevention, in professional mental health
- Clinician does risk assessment (ideation, plans, intent, means, etc.) - Clinician and patient develop safety plan (e.g., who to call, strategies for coping with suicidal thoughts) - In some cases, sign no-suicide contract
Psychotic Features Specifier
Hallucinations: Sensory experience in the absence of sensory input Delusions: Strongly held inaccurate beliefs
Double depression
a moderately depressed mood that persists for at least 2 years and is punctuated by periods of major depression
Unipolar Mood Disorder
a mood disturbance usually marked by depression or mania only. only one extreme of mood is experienced.
Mood disorders have a rapid rise in
adolescents
Major Depressive Episode
an extremely depressed mood sate that lasts at least 2 weeks and includes: - cognitive symptoms, such as feelings of worthlessness and indecisiveness. - disturbed physical functions, such as altered sleeping patterns, significant changes in appetite and weight, or notable loss of energy, to the point that event the slightest activity or movement requires an overwhelming effort.
Selective Serotonin Reuptake Inhibitors (SSRIs)
antidepressant drugs that achieve their agonistic effect on serotonin by selectively blocking its reuptake so there is more serotonin available to the brain.
Monoamine Oxidase Inhibitors (MAOIs)
antidepressant medications that increase the amount of monoamine neurotransmitter in synapses the enzyme breaks down serotonin/norepinephrine
What are the 2 types of cognitive errors?
arbitrary inference overgeneralization
The alternations between major depressive episodes and manic episodes is
bipolar I
The alternations between major depressive episodes and hypomanic episodes is
bipolar II
Someone who alternates between depression and mania is said to have a _______________________ traveling from one "pole" of the depression-elation continuum to the other and back again.
bipolar mood disorder
What does trycyclic antidepressants do?
block reuptake of norepinephrine and other neurotransmitters.
Mixed Reuptake Inhibitors
block reuptake of norepinephrine as well as serotonin
Bipolar Mood Disorder
both depressed and elevated moods are experienced some depressive episodes and some manic or hypomanic episodes
All of the specifiers for depressive disorders may also apply to bipolar disorders, especially the ___________ specifier.
catatonic
What specifiers apply to bipolar disorders?
catatonic psychotic anxious distress mixed features seasonal pattern peripartum
A serious condition involving an absence of movement or ___________, in which the muscles are waxy and semirigid, so a patient's arms or legs remain in any position in which they are placed.
catelepsy
Bipolar is the same in ______, ________, and ______
childhood, adolescence, and adults
Depressive Disorders are very rare in
children
In some _________ and ___________, the sudden loss of a parent makes them particularly vulnerable to severe depression.
children and young adults
All mood disorders occur in
children, adults, and elderly
Suicide is more common among women in
china
Cyclothymic Disorder
chronic (at least 2 years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes.
Premenstrual dysphoric disorder (PMDD)
clinically significant emotional problems that can occur during the premenstrual phase of the reproductive cycle of a woman.
What is the 2nd leading cause of death in
college students
SSRIs negative side effects are
common
Trycyclic Antidepressants discontinuation is _____________
common
The low grade version of bipolar disorder is
cyclothymic
The alternations between less severe depressive and hypomanic periods is
cyclothymic disorder
This is a criteria for what disorder? - Alternating between periods of mild depressive symptoms and mild hypomanic symptoms - Episodes do not meet criteria for full major depressive episode, full hypomanic episode, or full manic episode - Hypomanic or depressive mood states may persist for long periods - Must last for at least two years (one year for children and adolescents)
cyclothymic disorder
This is the DSM-5 criteria for what disorder? A. For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. B. During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. C. Criteria for a major depressive, manic, or hypomanic episode have never been met. D. The symptoms in criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. E. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: With anxious distress
cyclothymic disorder
The rare individual who suffers from manic episodes alone also meets criteria for bipolar mood disorder because experience shows that most of these individuals can be expected to become __________ at a later time.
depressed
In order for someone to be diagnosed with major depressive episodes, he or she needs to have 5 or more of the following symptoms present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either __________________ or _____________________
depressed mood loss of interest or pleasure
In previous editions of the DSM, _____________ could not be diagnosed during periods of mourning.
depression
Seasonal Pattern Specifier
depression occurring primarily in certain seasons (usually winter) Sometimes called seasonal affective disorder. Result of phase-delayed circadian misalignment, meaning that the patient's circadian rhythm is misaligned with the environmental day-night cycle May be treated effectively with light therapy
Psychological vulnerabilities in individuals with depression include
depressive cognitive style
Peripartum Specifier
depressive episodes during pregnancy or within 4 weeks of childbirth
Mixed Features Specifier
depressive episodes which also include several manic symptoms at least 3 symptoms of mania.
An example of mixed features:
depressive episodes with some manic features manic episode with some depressed/anxious features
For major depressive disorder, _______________________ system activation is reduced.
dopamine neurotransmitter
In the endocrine system, individuals with mood disorders have __________ cortisol.
elavated
Mood disorders are composed of different types of mood
episodes
Bipolar disorders approximately _________ affect both genders.
equally
Integrated Grief
eventual coming to terms with meaning of the loss
Catatonic Features Specifier
extremely rare muscular symptoms such as remaining in a still stupor, "waxy" limbs that remain in place when manipulated, repetitive or purposeless movement
Significant weight loss when not dieting or weight gain is a criteria for major depressive episodes, but what can be noted in children?
failure to make expected weight gains.
_________ therapy can be helpful for bipolar disorders.
family
euphoria
feeling of extreme happiness
Heritability rates for mood disorders are higher for ____________
females
Major depressive disorder in adolescents is largely _________
females
What gender attempts suicide more often?
females
________ are twice as likely to have major depression.
females
__________ are more likely to be in depressive period than in a manic.
females
___________ more likely to experience rapid cycling.
females
A major depressive episode is typically accompanied by a
general loss of interest in things and an inability to experience any pleasure from life (anhedonia), including interactions with family or friends.
Depressed individuals exhibit ________________ of their brains, particularly in the ______________
greater right-sided anterior activation; prefrontal cortex
In recent DSM, it is recognized that major depression may occur as part of the
grieving process
Mood disorders are characterized by
gross deviations in mood
Mood Disorders
group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression
Some research indicates that a person is more likely to commit suicide after
hearing about someone else committing suicide
Children are being diagnosed with bipolar disorders at increasingly ______________
high rates
What is a less severe version of a manic episode that does not cause marked impairment in social or occupational functioning and need last only 4 days rather than a full week?
hypomanic episode
Sleep deprivation may temporarily __________ depressive symptoms in bipolar patients.
improve
Depression may follow marked hopelessness about coping with the difficult life events. The depressive attributional style is
internal stable global
Persistent Depressive Disorder (Dysthymia)
involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair, present for at least 2 years, with no absence of symptoms for more than 2 months even if they may not experience all of the symptoms of a major depressive episode.
Depressed moods most of the day, nearly every day (feels sad or empty) are part of the criteria for major depressive episodes, but what moods are noted in children and adolescence?
irritable mood
Hippocampus
is responsible for keeping stress hormones in check.
If onset for major depressive disorder (dysthymia) is at age 21 years or older; specify (for most recent 2 years of dysthymic disorder), then it is
late onset
Lack of social support predicts
late onset depression
What is the advantage of PMDD?
legitimizes the difficulties some women face when symptoms are very severe
Sleep pattern disturbances in depressed children are _______ pronounced than in adults.
less
Hypomanic Episode
less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders. it may not be problematic in and of itself.
Trycyclic antidepressants may be ____________ in excessive doses.
lethal
The disparity of suicide is due to males using more
lethal methods
When it comes to psychosocial treatments for bipolar disorder, medications, usually __________ is still first line of defense.
lithium
What is a treatment of choice for bipolar disorders that is considered to be a mood stabilizer because it treats depressive and manic symptoms?
lithium carbonate
What is a treatment of choice for bipolar disorders that is toxic in large amounts and is effective in 50% of patients?
lithium carbonate
Psychosocial treatments for depression have _________________ effectiveness than medication.
longer-lasting
There is evidence that SSRI use during pregnancy _______________ risk for birth complications.
lowered
For a __________ ___________ episode, within a 2-week period, the individual needs to display any of the 5 symptoms in the DSM-5 criteria.
major depressive
One or more major depressive episodes separated by periods of remission. Single episodes are highly unusual. Recurrent episodes are more common. What disorder is this?
major depressive disorder
Acute Grief
occurs immediately after loss
Adolescents experience major depressive disorder about as _________ as adults.
often
In order for someone to be diagnosed with major depressive disorder, at least ______ major depressive episode occurred.
one
Depression and anxiety may often share a common, genetically determined biological vulnerability can be described as an
overactive neurobiological response to stressful life events.
Arbitrary Inference
overemphasize the negative aspects of a mixed situation instead of the positive
Mania
period of abnormally excessive elation (great happiness) or euphoria
Complicated Grief
persistent acute grief and inability to come to terms with loss
The only people who will not have suicidal ideation are those with ___________ out of all mood disorders.
persistent depression disorder
A low grade version of depression in which for 2 years, the individual has felt sad and worthless, but never had suicidal ideation.
persistent depressive disorder
About 20% of patients with major depressive disorder report chronicity of this episode for at least 2 years, thereby meeting criteria for
persistent depressive disorder
Ayana has had some mood disorder problems in the past, although some days she's better than others. Many days it seems like she has fallen into a rut. Although she manages to get by, she has trouble making decisions because she doesn't trust herself.
persistent depressive disorder
The following clinical criteria belongs to which depressive disorder? At least two years of depressive symptoms - Depressed mood most of the day on more than 50% of days - No more than 2 months symptom free - Symptoms can persist unchanged over long periods (≥ 20 years) - May include periods of more severe major depressive symptoms Major depressive symptoms may be intermittent or last for the majority or entirety of the time period
persistent depressive disorder
The following DSM-5 criteria belongs to which disorder? A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. B. Presence, while depressed, of two (or more) of the following: 1. Poor appetite or overeating 2. Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self-esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in criteria A and B for more than 2 months at a time. D. Criteria for major depressive disorder may be continuously present for 2 years. E. There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder. F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
persistent depressive disorder (dysthymia)
What are the most central indicators of a full major depressive episode?
physical changes "sometimes called somatic or vegetative symptoms." behavioral and emotional "shutdown"
Stress's relation to mood disorders results in ________ response to treatment.
poorer
Mood disorders occur less often in
prepubertal children
Atypical Features Specifier
presence of several symptoms less common in depression, including oversleeping and overeating
Depressed patients have a ________ and more __________ REM sleep.
quicker; intense
The suicide rate is higher among women in China. This may reflect cultural acceptability; suicide is seen as an honorable solution to
problems.
According to the permissive hypothesis, when serotonin levels are low, other neurotransmitters are "permitted" to
range more widely, become dysregulated, and contribute to mood irregularities, including depression.
What is a specifier unique to bipolar disorders?
rapid cycling specifier
What specifier is described here? - Moving quickly in and out of mania and depression - Individual experiences at least four manic or depressive episodes within a year - Occurs in between 20 to 50% of cases - Associated with greater severity
rapid cycling specifier
It is very ________ for someone to develop bipolar disorder after the age of 40.
rare
Substantial social support predicts ________ from depression.
recovery
If 2 or more major depressive episodes occurred and were separated by at least 2 months during which the individual was not depressed, the major depressive disorder is noted as being
recurrent
What is one thing that is important in preventing suicide?
removing access to lethal methods
All three domains of depressive attributional style contribute to a
sense of hopelessness
Mood disorders are related to low levels of ___________.
serotonin
What is one genetic pattern implicated in the biological vulnerability of depression?
serotonin transporter gene-linked polymorphic region.
Premenstrual dysphoric disorder
significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment
The prevalence of depression seems to be ________ across subcultures.
similar
There is a _________ prevalence of mood disorders among U.S. subcultures.
similar
What is a hallmark of most mood disorders?
sleep disturbance
Some symptoms, or ___________, may or may not accompany a depressive disorder.
specifiers
What types of hormones are elevated in patients with depression?
stress
_________ is strongly related to mood disorders.
stress
The onset, maintenance, and treatment of mood disorders is affected by:
stressful life events social support differential response to medication
What is the 11th leading cause of death in the US?
suicide Underreported; actual rate may be 2 to 3 times higher
flight of ideas
symptom of mania that involves an abruptly switching in conversation from one topic to another
What is the 3rd leading cause of death among
teenagers
What is a key identifying feature of bipolar disorders?
tendency of manic episodes to alternate with major depressive episodes in an unending roller-coaster ride from the peaks of elation to the depths of despair.
What is the difference between cyclothymic disorder and bipolar I and II?
the criteria for a major depressive, manic, or hypomanic episode have never been met.
What are the diagnostic specifiers for depressive disorders?
they are an additional diagnostic label used by clinicians to convey extra information about symptoms. they are NOT mandatory
What is the duration of depressive disorders?
they are variable in length - they can last several months untreated, but may last several years.
Depressive cognitive triad
thinking errors by depressed people negatively focused in three areas: themselves, their immediate world, and their future
Individuals who are depressed engage in cognitive errors by
thinking negatively about themselves, their immediate world, and their future.
What are tricyclic antidepressants?
tofranil and elavil
The mechanisms of __________ antidepressants are not well understood.
trycyclic
What is the structure of mood disorders?
unipolar mood disorder bipolar mood disorder
Individuals who suffer from either depression or mania are said to suffer from a
unipolar mood disorder because their mood remains at one "pole" of the usual depression-mania continuum.
What is the best known mixed reuptake inhibitor?
venlafaxine (effexor)
__________ ____________ generally more effective at preventing relapse
Psychosocial interventions
______________ helpful in managing the problems such as interpersonal occupational that accompany bipolar disorder.
Psychotherapy
T/F: Women are approximately twice as likely as men to be diagnosed with a mood disorder
T
T/F: some specifiers apply only to major depressive disorder, but some apply to both major depressive disorder and persistent depressive disorder.
T
What medications are used to treat mood disorders?
Antidepressants - Selective serotonin reuptake inhibitors - Tricyclic antidepressants - Monoamine oxidase inhibitors - Mixed reuptake inhibitors (e.g., serotonin/norepinephrine reuptake inhibitors)
A high school student may think she is a horrible teacher because 2 students fell asleep in her class. What type of cognitive error is this?
Arbitrary Inference
What are the types of Bipolar Disorders?
Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder
What psychosocial treatment for depression is being described? - Addresses cognitive errors in thinking - Also includes behavioral components including behavioral activation (scheduling valued activities)
CBT
What are the psychosocial treatments for depression?
CBT Interpersonal psychotherapy
What preventative programs are there for at-risk groups?
CBT can reduce suicide risk
What disorder is being described? - Severe temper outbursts occurring frequently, against a backdrop of angry or irritable mood. - Diagnosed only in children 6 to 18 - Criteria for manic/hypomanic episode are not met - Designed in part to combat overdiagnosis of bipolar disorder in youth
Disruptive Mood Dysregulation Disorder
What treatment for mood disorders is being described? - Effective for medication-resistant depression - The nature of it: Brief electrical current applied to the brain Results in temporary seizures Usually 6 to 10 outpatient treatments are required - Side effects: Short-term memory loss which is usually restored Some patients suffer long-term memory loss Mechanism is unclear
Electroconvulsive Therapy (ECT)
T/F: Depression requires some life experience, indicating that babies and young children cannot experience the disorder.
F
Talking to someone about suicide is _____ likely to place them at greater risk or "plant the idea"
not
What psychosocial treatment for depression is being described? Focus: Improving problematic relationships
Interpersonal psychotherapy
What is the difference between mood dysregulation and bipolar disorder?
MDD does not involve criteria for manic/hypomanic
Learned Helplessness Theory of Depression
Martin Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they actually have control).
What are the different types of PDD?
Mild depressive symptoms without any major depressive episodes ("with pure dysthymic syndrome") Mild depressive symptoms with additional major depressive episodes occurring intermittently (previously called "double depression") Major depressive episode lasting 2+ years ("with persistent major depressive episode")
What are the symptoms of PMDD?
Mood swings, sensitivity, etc Irritability or anger Depressed mood Anxiety and tension Decreased interests in usual activities Difficulty concentrating' Lethargy Change in appetite Problems sleeping Feeling out of control Physical symptoms
When your professor makes one critical remark on your paper, you then assume you will fail the class. What type of cognitive error is this?
Overgeneralization
A very significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment.
PMDD
Evidence best indicates that ___________ is best considered a disorder of mood as opposed to a physical disorder.
PMDD
What is the gene-environment correlation in mood disorders?
People who are vulnerable to depression might be more likely to enter situations that will lead to stress
What are the possible explanations for gender disparity?
Possible explanations for gender disparity - Women socialized to have stronger perception of uncontrollability - Parenting style makes girls less independent - Women more sensitive to relationship disruptions (e.g., breakups, tension in friendships) - Women ruminate more than men
What psychosocial treatment for depression is being described? Preemptive psychosocial care for people at risk
Prevention
Media accounts may worsen the problem with suicide by
Sensationalizing/romanticizing suicide Describing lethal methods of committing suicide
(T/F) Somatic symptoms characterizing mood disorders are nearly equivalent across cultures
T
T/F: An occurrence of just one isolated depressive episode in a lifetime is now known tot be relatively rare.
T
T/F: Bipolar disorder seems to occur at about the same rate in childhood and adolescence as in adults.
T
T/F: It's often difficult to diagnose depression in the elderly because its symptoms are similar to those of medical ailments or dementia.
T
T/F: Not even the tendency to cry reflect severity or even the presence of a depressive episode as much as anhedonia.
T
T/F: PMDD was part of a very controversial diagnosis.
T
T/F: Psychosocial and pharmacological treatments are both used
T
What treatment for mood disorders is being described here? - Uses magnets to generate a precise localized electromagnetic pulse - Few side effects; occasional headaches - Less effective than ECT for medication-resistant depression - May be combined with medication
Transcranial Magnetic Stimulation
Lithium carbonate
a common salt
Mixed Features
a condition in which the individual experiences both elation and depression or anxiety at the same time. Also known as dysphoric manic episode or mixed manic episode.
The following DSM-5 criteria refers to which disorder? A. At least one major depressive episode (DSM-5 Table 7.1 Criteria A-C). B. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. C. There has never been a manic episode or hypomanic episode. Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance induced or are attributable to the direct physiological effects of another medical condition. Specify the clinical status and/or features of the current or most recent major depressive episode: Single episode or recurrent episode; Mild, moderate, severe; With anxious distress; With mixed features; With melancholic features; With atypical features; With mood-congruent psychotic features; With mood-incongruent psychotic features; With catatonia; With peripartum onset; With seasonal pattern (recurrent episode only); In partial remission, in full remission
major depressive disorder
For the past few weeks, Jennifer has been sleeping a lot. She feels worthless, can't get up the energy to leave the house, and has lost a lot of weight. Her problem is the most common and extreme mood disorder.
major depressive episode
The following DSM-5 criteria belongs to which disorder? A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition or mood-incongruent delusions or hallucinations. 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: in children and adolescents can be irritable mood. 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others). 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: in children, consider failure to make expected weight gains 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) 6. Fatigue or loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
major depressive episode
Which depression is the most commonly diagnosed and most severe?
major depressive episode
Melancholic Features Specifier
major depressive episode accompanied by additional severe symptoms such as early morning awakenings, lack of reactivity to positive stimuli, loss of libido (sex drive), anhedonia.
Depression and mania include periods of depressed or elevated mood lasting days or weeks. They include:
major depressive episodes manic episodes hypomanic episodes
One thing related to depression is marital dissatisfaction. This relation is strong in ___________
males
Which gender completes more suicides?
males
An abnormally exaggerated elation, joy, or euphoria is known as
mania
Feeling certain he would win the lottery, Charles went on an all-night shopping spree, maxing out all his credit cards without a worry. We know he's done this several times, feeling abnormally extreme elation, joy, and euphoria.
mania
Unlike patients with major depressive episodes, during a ___________ __________ individuals find extreme pleasure in every activity; some patients compare their daily experience with a continuous sexual orgasm.
maniac episode
For __________ episode, within a 1-week period, the individual needs to display 3 of the symptoms listed in the DSM-5
manic
The following symptoms are displayed in patients having a _________ episode. - inflated self-esteem - decreased need for sleep - excessive talkativeness - flight of ideas or sense that thoughts are racing - easy distractibility - increase in goal-directed activity or psychomotor agitation - excessive involvement in pleasurable but risky behaviors - impairment in normal functioning
manic
In order to be diagnosed with Bipolar I, you need to have had a __________ episode.
manic (1-week period in which they reported having 3 or more of the symptoms)
There is a high prevalence of mood disorders among ____________
native americans
Depression may result from a tendency to interpret everyday events in a _________ way.
negative
Internal
negative outcomes are one's own fault
Overgeneralization
negatives apply to all situations
Long-term overproduction of stress hormones makes an organism unable to develop new neurons in the hippocampus, this is called
neurogenesis
Serotonin regulates
norepinephrine and dopamine
The following DSM-5 criteria belongs to which disorder? A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary). B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior: 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) 3. More talkative than usual or pressure to keep talking 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (e.g., purposeless non-goal-directed activity). 7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. D. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another general medical condition.
manic episode
A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence of a
manic episode and, therefore, a bipolar I diagnosis.
In order to be diagnosed with cyclothymic disorder, they could never have had a ___________________ episodes.
manic/hypomanic (they could have had the symptoms but did not meet full criteria)
In order to diagnose someone with major depressive disorder, what episodes cannot be listed that they had?
manic/hypomanic episodes (related to bipolar)
For people with bipolar disorders, the key treatment is
medication
The risk of depressive disorders decreases in
middle adulthood, but increases in old age.
The term for a mood episode with some elements reflecting the opposite valence of mood.
mixed features
What antidepressants for mood disorders have fewer side effects than SSRIs?
mixed reuptake inhibitors
What antidepressant for mood disorders is as affective as tricyclics but with fewer side effects?
monoamine oxidase inhibitors
What antidepressant for mood disorders is dangerous in combination with certain foods: Beer, red wine, cheese cannot be consumed; patients dislike dietary restrictions Also dangerous in combination with cold medicine
monoamine oxidase inhibitors
The fundamental experiences of depression and mania contribute, either singly or together, to all the
mood disorders
Relatives of bipolar probands are ____________ to have unipolar depression.
more likely
What is the prevalence for depressive disorders?
more likely in women
Major Depressive Disorder
most easily recognized mood disorder defined by the presence of depression and the absence of manic, or hypomanic episodes, before or during the disorder.
Anxious Distress Specifier
most important specifier depression is accompanied by several significant symptoms of anxiety Predicts poorer outcome from treatment. Suicidal thoughts and suicide are more likely.
Suicide is most common among
white and native americans
If full criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in at least the preceding 2 years with symptoms below the threshold for a full major depressive episode, then
with intermittent major depressive episodes, with current episode.
If full criteria for a major depressive episode are not currently met, but there has been one or more major depressive episodes in at least the preceding 2 years, then
with intermittent major depressive episodes, without current episodes.
If full criteria for a major depressive episode have been met throughout the preceding 2-year period, then
with persistent major depressive episode
If full criteria for a major depressive episode have not been met in at least the preceding 2 years, then
with pure dysthymic syndrome
Suicide is prevalent in
young adults
__________ ___________ typically don't show classic mania or bipolar symptoms.
young children