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CH 8 - Mood Disorders and Suicide

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Section 1

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Types of Bipolar Disorders

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6 years ago

Date created

Mar 14, 2020

Cards (14)

Section 1

(14 cards)

Types of Bipolar Disorders

Front

Bipolar I = mania + depressive episode Bipolar II = Hypomania + depressive episode Cyclothymia = chronic pattern of hypomania and short depressive episodes lots of highs and lows

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Hypomania DSM-5 criteria

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= slightly less intense, still need 3 symptoms but only need to be present for 4 days

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Mania/manic episode DSM-5 criteria

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Major Depressive Disorder (MDD)

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- Need 5+ symptoms within same 2 week period; 1 of the 5 must be a cardinal symptom Cardinal Symptoms: 1. Depressed Mood most of the day, nearly every day (by subjective report or observation). (NOTE: can be irritable in children and kids) 2. Anhedonia = marked diminished interest or pleasure in all or almost all activities OTHER: 1. Significant weight loss or gain (> 5% body weight in a month), or increase or decrease in appetite nearly every day 2. Insomnia or hypersomnia 3. Psychomotor agitation or retardation (observable by others) 4. Fatigue 5. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) 6. Diminished ability to think/concentrate or indecisiveness 7. Thought of death/suicide (with or w/o plan)

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Specifiers for Mood Disorders:

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Psychotic Features: mood-congruent vs. Mood incongruent psychosis Melancholic Features = (andogenous) don't need any external stressor, it's biological/genetic, hypersomnia, Atypical Features = increased appetites and insomnia, extreme rejection sensitivity, intact mood reactivity (so not anhedonic) - Responds best to MAOI's not tricyclics (SSRI's) - MOST COMMON Seasonal Pattern: Seasonal Affective Disorder = when ppl consistently experience depressed mood in the winter months Peri/Postpartum Onset: onset in last month of pregnancy or post-birth Chronic Major Depression = meet full criteria for MDD and lasts 2+ years - Less responsive to most treatments

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Explain the evolution of the terminology for Mood Disorders:

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Emile Kraepelin - "manic depressive illness" Karl Abram + Freud - Drew parallel b/w depression = grief (loss) Karl Leonhard - Proposed unipolar-bipolar distinction DSM-5 - Are both in the same chapter but separated into "Depressive related disorder" and "Bipolar related disorders"

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rapid cyclers

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= 4+ episodes w/i a year- - episodes must be separated by 2 months OR by switch in episode type (mania vs. depression) (specifier of bipolar NOT subset)

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mood-congruent vs. Mood incongruent psychosis (in mania vs. in depression)

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mood-congruent MANIA: see themselves as amazing, possessing special qualities, perhaps a religious figure (Gay Jesus) DEPRESSION: a feeling of guilt or sin (i.e. Confessing to crimes they didn't do) or delusions of having illnesses they don't have or nihilistic delusions (e.g. the world is ending) Mood-incongruent MAINA: thought insertion + mind control (Kanye) DEPRESSION: anything happy (very rare)

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what is the significant brain region related to bipolar? what does it predict?

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the striatum (reward processing) - an enlarged striatum is a vulnerability marker BUT not a guarantee that BD will develop (twin study, both had enlarged even though only one actually had dx)

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chronic major depression

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= meet full criteria for MDD and lasts 2+ years = specifier of depressive disorder

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Types of Depressive Disorders (3)

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Major Depressive Disorder (MDD) Persistent Depressive Disorder (Dysthymic Disorder) (PDD) Premenstrual Dysphoric Disorder

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Persistent Depressive Disorder (PDD)

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= (formerly dysthymic) milder chronic form of depression (2 yrs in adults and 1 year for kids)

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Premenstrual Dysphoric Disorder (PMDD)

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- Need 5+ symptoms - Must significantly interfere with functioning - Must be present for most menstrual cycles in the past year SYMPTOMS: - affective liability - irritability/anger - depressed mood - loss of interest in activities - low energy - changes in appetite - changes in sleep - concentration difficulties - feelings of loss of control

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Tripartite Model

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What is DISTINCT about Depression: anhedonia What is distinct about Anxiety? physiological hyperarousal What do they share? General distress/negative affect

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