Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
215 Cards in this Set
- Front
- Back
What are the two braod types of Mood Disorder
|
Unipolar and Bipolar
|
|
What are the cardinal symptoms of depression?
|
Profound sadness and/or an inability to experience pleasure
|
|
What are the three new depressive disorders proposed in the DSM-5?
|
mixed anxiety/depressive disorder, premenstrual disorder, and disruptive mood regulation disorder
|
|
What are the 5 depressive disorders in the DSM-5?
|
1. Major Depressive Disorder;
2. Dysthmia; 3. Mixed anxiety/depressive disorder; 4. Premenstrual dysphoric disorder; 5. Disruptive mood dysregulation disorder |
|
What are the three bipolar disorders?
|
1. Bipolar I;
2. Bipolar II disorder; and 3. Cyclothymia |
|
What are 5 physical symptoms commonly found in people with depressive disorder?
|
fatigue, sleeping problems, decrease sexual interest, psychomotor retardation, and psychomotor agitation
|
|
What are 6 common psychological symptoms of depressive disorders?
|
self-recrimination, difficulty paying attention, physical symptoms, reduced initiative, social withdrawal, and neglect of appearance
|
|
How many symptoms and for how long must they be present to be diagnised with MDD?
|
5 symptoms for 2 weeks
|
|
Symptoms of MDD must include depressed mood or what?
|
loss of interest or pleasure
|
|
Why is MDD regarded as an episodic disorder?
|
because symptoms tend to be present for a period of time and then disappear
|
|
What are the 7 symptoms, of which 5 must be present, in the DSM-5 criteria for MDD?
|
1. sleeping too much or too little;
2. psychomotor retardation or agitation; 3. weight loss or change in appetite; 4. loss of energy; 5. feelings of worthlessness or excessive guilt; 6. difficutly concentrating, thinking or making decisions; 7. recurrent thoughts of death or suicide |
|
What proportion of people who have suffered a Major depressive episode are likely to have a second episode?
|
two thirds
|
|
What is the average number of MDD episodes?
|
4
|
|
Each episode of MDD increases the risk of another episode by what percent?
|
16%
|
|
Chronic depression is known as what?
|
dysthmia
|
|
How many symptoms and for how long must they be present to be diagnised with dysthmia?
|
2 symptoms for 2 years
|
|
In dysthmia what proportion of the time do people need to experience a depressed mood to meet the criteria?
|
more than half the time
|
|
What percentage of people with dysthmia develop MDD over a 10 year period?
|
95%
|
|
The criteria for dysthmia requires that symptoms do not clear for what period of time over the 2 years?
|
2 months
|
|
What is the most prevalent psychiatric disorder?
|
MDD
|
|
Prevalence of MDD over the lifetime?
|
16%
|
|
Prevalence of dythmia?
|
2.50%
|
|
What is the Female Male ratio of MDD?
|
2 :1 ratio
|
|
How many times more common is MDD in low SES individuals?
|
three times
|
|
Is MDD or dysthmia more rare?
|
dysthmia
|
|
What is the prevalence of MDD in Taiwan and Lebanon?
|
1.5 Taiwan and 19% in Lebanon
|
|
Do symptoms of MDD vary across cultures?
|
yes
|
|
What symptoms of MDD are common is Latino cultures and Asian cultures?
|
nerves & headaches in latino, and fatigue and weakness in asians
|
|
What might symptoms of MDD show cross-cultural variation?
|
due to cultural standards regarding acceptable expressions of emotional distress
|
|
What changes in the rates of MDD and dysthmia are found in countries with high fish consumption?
|
lower rates of both
|
|
In most countries did the prevalence of MDD increase or decrease steadily until the late 20th century?
|
increased
|
|
Has the age of MDD onset become older or younger over time?
|
younger
|
|
What percentage of people in their 60's report an experience an episode MDD by age 20?
|
5%
|
|
What percentage of people in aged 18 to 29 report an experience an episode MDD by age 20?
|
10%
|
|
What is the median age of onset for MDD?
|
late teens , early 20's
|
|
What social change may explain the increase in rates of MDD and the lower age of onset?
|
reduced social support structures
|
|
What percentage of people who meet the criteria for MDD during their lifetime will also meet the criteria for an anxiety disorder at some point?
|
60%
|
|
What disorders are commonly comorbid with MDD?
|
anxiety, substance abuse, sexual dysfunctions, and personality disorders
|
|
What is the worlds leading cause of diability?
|
MDD
|
|
The further a person's distance from the equator the more they are at risk for developing which disorder?
|
MDD
|
|
There is strong evidence that depression is related to the onset and severity of which physical disease?
|
cardiovascular disease
|
|
IS MDD acute or chronic?
|
Acute
|
|
Is dysthmia acute or chronic?
|
chronic
|
|
Does dysthmia require more or less symptoms for a diagnosis than MDD?
|
less
|
|
What is the average duration of dysthmic symptoms?
|
more than 5 years
|
|
What differences in MDD symptomology are found in children vs older adults?
|
children often display somatic complaints, where older adults display distractibility and memory loss
|
|
Episodes of mood disorders that occur during certain seasons is known as what?
|
seasonal affective disorders
|
|
How does seasonal effective disorder affect depression and bipolar disorder?
|
in depression it typically worsens on late autumn to early spring, and for bipolar people are typically depressed in winter and manic in summer
|
|
What changes in sleep and appetite in SAD?
|
excessive sleep and decreased appetite
|
|
What hormone is implicated in SAD?
|
melatonin
|
|
What is the defining feature of bipolar?
|
mania
|
|
What differentiates each of the three bipolar disorders?
|
the severity and length of the mania
|
|
Which types of bipolar require the presence of depression and which don't?
|
diagnosis of depression is not required for bipolar I, but is required for bipolar II, and cyclothmic disorder
|
|
What are the three subtypes of MDD in the dSM-IV-TR?
|
single epsiode, recurrent, chronic substype
|
|
What 7 criteria of which 3 are required, or 4 if the mood is irritable, for a manic or hypomanic episode?
|
1. increased goal-directed activity or psychomotor agitiation;
2. unusual talkativeness/rapid speech; 3. flight of ideas or subjective impression that thoughts are racing; 4. decreased need for sleep; 5. increases self esteen/belief that one has special talents, powers, or abilities; 6. distractibitiity; 7. excessive involvement in acitivities that are likely to have undesireable consequences, such as reckless spending, sexual behaviour, or driving |
|
Aside from the list of symptoms, what are criteria are required for a manic episode?
|
1. distincly elelvated or irritible mood for most of the day;
2. (DSM-5) abnormally increased actvity and energy; 3. symptoms later one week or require hisoitalisation; 4. symptoms cause significant ditress or impairment |
|
What is the difference of criteria between a manic and a hypomanic episode?
|
Manic- required symptoms for be present for one week or require hisoptialisation, and symptoms cause significant distress or impair funcitoning; and
Hypomanic - symptoms last for 4 days, clear changes in functioning observable to others but impairment is not marked, and no psychotic symptoms are present |
|
What is it known as when a person shifts rapidly from topic to topic?
|
flight of ideas
|
|
What are the two chronic mood disorders?
|
dysthmia and cyclothymic disorder
|
|
Which form of bipolar requires only a single manic eopisode over the lifetime?
|
Bipolar 1
|
|
Which form of bipolar is considered a milder form?
|
bipolar II
|
|
What are the two criteria for bipolar II?
|
a person must have experienced at least one major depressive episode, and at least one episode of hypomania
|
|
How long must mild syptoms of depression alternating with mild symptoms of mania be present for to meet the criteria for cyclothmic disorder?
|
2 years
|
|
How long must symptoms be present in children to diagnose cyclothmic disorder?
|
1 year
|
|
In the criteria for cyclothmic disorder symptoms must not clear for more than what period of time for a diagnosis?
|
2 months
|
|
Prevalence of bipolar I?
|
0.06%
|
|
Prevalence of bipolar II
|
.4 to 2%
|
|
prevalence of cyclomythmic disorder?
|
4%
|
|
What proprtion of people diagnosed with a bipolar spectrum disorders report onset before age 25?
|
half
|
|
Bipolar occurs equally in men and woman but what symptoms occur more often in women?
|
depression
|
|
What proportion of people with bipolar disorder meet diagnostic criteria for a comorbid anxiety disorder?
|
two-thirds
|
|
What proportion if people with bipolar disorders meet diagnostic criteria for a comorbid substance abuse?
|
more than one third
|
|
What two disorders are commonly comorbid with bipolar disorder?
|
anxiety and substance abuse
|
|
Which type of bipolar is seen as one of the most severe forms of mental illness?
|
bipolar I
|
|
What percentage of the time is it estimated that people with bipolar unable to work?
|
25%
|
|
What proprtion of people remain unemployed for a year after hospitalisation?
|
one third
|
|
One in 4 persons with bipolar 1, and one in five with bipolar II report a history of what?
|
suicide attempts
|
|
People with bipolar disorders are at high risk of developing what four medical conditions?
|
cardiovascular disease, diabetes , obesity, and thyroid disease
|
|
rapid cycling is only diagnosed for which condition?
|
bipolar
|
|
Are the symptoms of mood disorders homogenous or heterogenous?
|
heterogeneous
|
|
People with cyclothymic disorder are at a high risk of developing what?
|
episodes of mania and depression
|
|
How many episodes must be present each year for rapid cycling?
|
4
|
|
A person who moves in and out of depression or manic episodes describes what mood disorder subtype?
|
rapid cycling
|
|
Which subtype of mood disorders tends to be resistent to treatment?
|
rapid cycling
|
|
Which mood disorder subtype is described as having delusion or hallucinations with themes that are consistent with mood state?
|
mood-congruent psychotic features
|
|
Which mood disorder subtype is described as having delusions or hallucinations with themes that do not match the valence of the depressive or manic episode?
|
mood-incongruent psychotic features
|
|
Which mood disorder subtype involves extreme physical immobility or excessive perculiar movements?
|
Catatonic
|
|
Which mood disorder subtype involves loss of pleasure in any acitivty, an inability to gain relief from positive events, and depressive symptoms are worse in the morning?
|
melancholic
|
|
Which mood disorder subtype symptoms that are unusual for depressive or manic episodes that are present, such as oversleeping and overeating can gain pleasure form acitivties?
|
Atypical
|
|
Which mood disorder subtype has an onset withint 4 weeks of giving birth?
|
postpartum
|
|
The heritability of mood disorders is what?
|
36%
|
|
The poly morphisms of what type of transporter gene is thought is implicated in mood disorders?
|
serotonin
|
|
How does mania present in children?
|
modd swings and irritability not as marked as in adults
|
|
Depression is fundamentally similar across the lifespan however what must clinicians look for when assessing for the presence of a mood disorders?
|
changes in behaviour
|
|
What comorbidity differences are found in children and adults with a mood disorder?
|
Adults typically comorbid with anxiety, whereas children are typically comorbid with AdHD and CD
|
|
What percentage of children with a mood disorders meet criteria for ADHD?
|
90%
|
|
MDD is common in people with polymrphism of which dopamine gene?
|
DRD4.2
|
|
Is it more likely to one gene or a set of genes is involved with mood disorders?
|
a set of genes
|
|
Which three neurotransmitters are implicated in mood disorders?
|
noreponephrine, dopamine, and serotonin
|
|
What is the primary function of serotonin?
|
regulate emotional reactions
|
|
Which of the three neurotransmitters implicated in mood disorders is thought to impact more than the others?
|
serotonin
|
|
Are serotonin low or high in mood disorders?
|
low
|
|
Is it the balance of the neurotransmitters or absolute levels of neurotransmitters that is important in mood disorders?
|
balance of the neurotransmitters
|
|
Dopamine plays a role in the sensitivity of which system?
|
reward system
|
|
What is the name of the brain system which is believed to guide pleasure, motivation, and energy in the context of opportunities to obtain rewards?
|
reward system
|
|
Among people with bipolar, drugs that increase dopamine have been found to trigger what?
|
a manic episode
|
|
In support of the reward system, diminished dopamine functioning in people with MDD can cause what type of deficits?
|
pleasure, motivation and energy
|
|
People with depression are less responsive than other people to drugs that increase what?
|
dopamine levels
|
|
What differences in dopamine sensitivity are found among those with depression and those with bipolar?
|
people with depression are less sensitive to dopamine, and people with bipolar are more sensitive to dopamine
|
|
A person who has insensitive serotonin receptors is expected to experience what symptoms as levels drop?
|
depression
|
|
What difference in serotonin sensitivity is found among those with depression and those with bipolar?
|
both conditions show a diminished sensitivitiy of the serotonin receptors
|
|
What are the four primary brain structures involved with depression?
|
amygdala, prefrontal cortex, sub-genual anterior cingulate, and hippocampus
|
|
What brain structure helps a person assess how emotionally important a stimulus is?
|
amygdala
|
|
Is hyperactivity of the amygdala in people with MDD a predisposing factor or a resulting factor of MDD?
|
both
|
|
Functional brain activation studies show elevated levels of acitivity in the amygdala among people with which disorder?
|
MDD
|
|
Of the four brain structures implicated in MDD and bipolar 1 disorder which 2 are hyperreactive and which two have diminshed reactivity in people with MDD and bipolar?
|
the amygdala and sub-genual anterior cingulate show hyperreactivity, and the prefrontal cortex and hippocampus show diminshed reactivity
|
|
Brain patterns shown during mania are similar to the patterns shown during what?
|
depression
|
|
Which other brain structure linked to the reward system is overly active in people with mania but not in people with depression?
|
striatum
|
|
People with MDD have increases reaction to emotions but a decreased ability to do what?
|
plan
|
|
People with bipolar disorder often have deficits in the membranes of what which influences how readily they can be activated?
|
neurons
|
|
Which type of protein is abnormally high among people with mania?
|
protein kinase C
|
|
Which axis is involved in MDD?
|
HPA
|
|
Too much cortisol resutls in what sort of symptoms?
|
depressive symptoms
|
|
Is high or low levels of cortisol linked to depression?
|
high
|
|
What does dexamethasone do?
|
suppresses cortisol secretion
|
|
Dexamethasone does not adequeately suppress cortisol secretion in people with MDD and particularly in those showing what type of symptoms?
|
psychotic
|
|
At times of stress and increased activity of the immune system what hormone is secreted to help the body prepare for threats
|
cortisol
|
|
Dexamethasone suppresses cortisol over the course of what?
|
the night
|
|
The lack of cortisol suppression is seen as poor regulation of what in people ith MDD?
|
HPA axis
|
|
Long-term excesses of cortisol have been linked to damage and shrinkage of what brain structure?
|
hippocampus
|
|
The HPA axis manages rectivity to what?
|
stress
|
|
The HPA axis receives signals from what brain structure causing it to acitivate?
|
amygdala
|
|
Do life events typically happen before or after a depressive episode?
|
before
|
|
What percentage of people report a serious life event before the onset of depression?
|
42 to 67%
|
|
What are two types of life events that appear to trigger depressive episodes?
|
loss & humiliation
|
|
Do life events tend to trigger initial episodes of depression or subsequent episodes?
|
initial episodes
|
|
In what way do adequate social support networks protect against mood disorders?
|
adequate social support help a persons handle stressful life events
|
|
What term describes a family member's critical or hostile comments toward or emotional involvement with the person with depression?
|
expressed emotions (EE)
|
|
What does high EE predict?
|
a relapse in depression
|
|
What percentage of patients in families with high EE relapsed within one year? and with low EE?
|
69.5% high EE compared to 30.5% low EE
|
|
Depressive symptoms seem to eleicit what kind of reactions from others?
|
negative
|
|
Interpersonal problems are a risk factor for what?
|
depression
|
|
What impact can seeking reassurance from others have on a person with depression?
|
elicit a negative response from others which may contribute to the onset of a depressive episode
|
|
Those with anxiety and depression generally have what sort of affect?
|
negative
|
|
What is the primary difference in affect between people with depression and people with anxiety?
|
People with depression experience a lack of positive affect while people with anxiety do not
|
|
Which personality factor tends to predict the onset of depression?
|
neuroticism
|
|
Why does neuroticism predispose people to depression?
|
because high neurotocism is the tendency to react to events with greater negative affect
|
|
Which cogntive theory is most influential in the aetiology of depression?
|
Beck's Theory
|
|
What are the three main cognitive theories implicated in the aetiology of depression?
|
Beck's Theory, Hopelessness Theory, and Rumination Theory
|
|
Which cognitive theory emphasises the negative triad?
|
Beck's Theory
|
|
What is the negative triad?
|
negative views of self, the world, and the future
|
|
According to Beck' Theory what do people acquire during childhood through experiences such as loss of a parent, the social rejection of peers, or the depressive attitude of a parent?
|
negative schema
|
|
What are schemas?
|
underlying sets of beliefs that operate outside of the persons awarenes to shape the way a person makes sense of his or her experiences
|
|
When is a negative schema activated?
|
when the person encounters situations similar to those that originally caused the schema to form
|
|
The tendency to process information in certain negative ways is known as what?
|
negative bias
|
|
Once activated negative schemas are believed to cause what?
|
cognitive bias
|
|
According to Beck's Theory people who are depressed make certain cognitive errors to arrive at what?
|
biased conclusions
|
|
What widely used self report instrument has been used in stidies of Beck's Theory?
|
DAS - Dysfunctional Attitudes Scale
|
|
People with depression have a tendency to focus on what once it is noticed?
|
negative information
|
|
People with depression tend to have a negative bias toward what information processing functions?
|
what information they attend to and retain
|
|
According to which theory the most important trigger of depression is hopelessness?
|
Hopelessness Theory
|
|
An expectations that desirable outcomes witll not occur and that the person has no responses available to change the situation is known as what?
|
hopelessness
|
|
Stable and global attribution about the event and it's meaning for the future or self leads to what?
|
hopelessness
|
|
What are the two key dimensions of attribution implicated in the hopelessness theory?
|
stable vs unstable and global vs specific causes
|
|
How does low self esteem promote hopelessness?
|
it undermines the confidence that a person can cope with life challenges
|
|
How does rumination contribute to the onset of a depressive episode?
|
it t interferes with problem solving and increases negative mood
|
|
What type types of factors have been found to predict increases in manic symptoms over time?
|
reward sensitivity and sleep deprivation
|
|
Being highly reward sensitive has been shown to predict what?
|
the onset of bipolar disorder and a more severe course of mania after onset
|
|
What type of life events seem to precipitate the onset of bipolar or a manic episode?
|
life events that involve attaining goals
|
|
Excessive goal pursuit may trigger what in people with bipolar disorder?
|
manic symptoms
|
|
Mania is intricately tied to disruptions in what?
|
sleep and circadian rhythms
|
|
Sleep deprivation can precede the onset of what in people with bipolar disorder?
|
manic episode
|
|
Protection of what daily function can help reduce symptoms of bipolar disorder?
|
sleep
|
|
Depression and anxiety share what?
|
a genetic vulnerabitilty
|
|
Interpersonal relationship can act as what for depression?
|
protective or risk factor
|
|
What are the four psychological treatments for depression?
|
Interpersonal psychotherapy, Cognitive Therapy, Behavioural Activation Therapy, and Behavioural Couples Therapy
|
|
What does IPT stand for?
|
Interpersonal Therapy
|
|
What idea does IPT build on?
|
the idea that depression is closely tied to interpersonal problems
|
|
What is the core of IPT?
|
to examine major interpersonal problems, such as role transitions, interpersonal conflicts, bereavement, and interpersonal isolation
|
|
What is the typical number of sessions for IPT?
|
16
|
|
What are the 5 techniques used in IPT?
|
1. disucssing interpersonal problems;
2. exploring negative feelings and encouraging their expression; 3. improving both verbal and nonverbal communications; 4. problem solving; 5. suggesting new and more satisfying modes of behaviour |
|
What are the 3 goals of IPT?
|
helping the person identify his or her feelings about the issues, make important decisions, and make changes to resolve problems related to these issues.
|
|
Cognitive therapy is aimed at altering what?
|
maladaptive thought patterns
|
|
An adaption of CT called mindfulness-based cognitive therapy (MBCT) focuses on what?
|
relapse prevention after successful treatment for recurrent episodes of MDD
|
|
Behavioural Activation Therapy is based on what idea?
|
that many of the risk factors for depression can result in low levels of positive reinforcement and that increasing engagement in rewarding acitvities will alleviate depression through increased positive reinforcement
|
|
What is the purpose of behavioural couples therapy?
|
improve communicate and relationship satisfaction and therefore alleviating depression
|
|
What is a necessary part of treatment for bipolar disorder?
|
medication
|
|
What is an inherent problem with medicating people with bipolar disorder?
|
high rates non adherence
|
|
What are three psychological treatments that are effective for treating bipolar disorder?
|
Psychoeducation, CBT and FFT
|
|
What is the aim of family focussed treatment in people with bipolar disorder?
|
to educate the family about the illness, enhance family communication, and develop problem solving skills
|
|
What are the two main biological treatment for MDD?
|
ECT and medication
|
|
What are the three types of medication used to treatment depressive disorders?
|
SSRI's, Mao inhibitors, and Tri-cyclic antidepressants
|
|
Which type of antidepressant is more effective in the treatment of depressive disorders?
|
all equally effective
|
|
Combining psychotherapy with antidepressant drugs in the treatment of depressive disorders increases the effectiveness by what perentage?
|
20%
|
|
What percentage of people with depression show major improvement after taking AD medication?
|
50 to 70%
|
|
What is the most commonly prescribed AD medication?
|
SSRI's
|
|
What are some side effects of SSRI's?
|
physical agitation, sexual dysfunction, insomnia, gastrointestinal upset
|
|
What does MAO stand for?
|
Mono-amine oxidase inhibitor
|
|
What can sometimes be a serious temporary side effect of SSRI's particualrly found in adolescents?
|
increases thoughts of suicide
|
|
MAO's inhibitor block which enzyme?
|
Mono-amine oxidase
|
|
What are the two potential serious side effects of MOA inhibitors?
|
consuming anything containing tyramine can lead to hypertension, and everyday medication interactions are dangerous
|
|
What does MOA breakdown?
|
noreponephrine, dopamine, and serotonin
|
|
What common food and drink is tyramine found in?
|
wine, cheese, and beer
|
|
Which AD medication is lethal if taken in high doses?
|
tricyclic AD's
|
|
What are the disruptive side effects of tricyclic AD's?
|
blurred vision, dry mouth, drowsiness, and weight gain
|
|
Medications that reduce manic symptoms are known as what?
|
mood stabilisers
|
|
What is the common drug used to treat bipolar disorder?
|
lithium
|
|
What percentage of people receive some benefit from taking lithium?
|
80%
|
|
What percentage of people who take lithium relapse within 5 years?
|
70%
|
|
What are some serious side effects of lithium?
|
coma, and even death
|
|
What other two medications are used when lithium doesn't work?
|
anticonvulsives and antipsychotics
|
|
What is the main reason a person with bipolar will cease taking lithium?
|
because it flattens affect
|
|
When is ECT used to treat MDD?
|
when all other treatments and medications fail
|
|
What are the main side effects for ECT?
|
short-term memory loss and cognitive decline for up to 6 months
|
|
What voltage current is used in ECT?
|
70 to 130 volts
|