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mood disorders 1
21
Psychology
Undergraduate 3
11/14/2011

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Term
general layout of mood disorders
Definition
-mood disorders
-bipolar disorders
-bipolar disorder
-bipolar 1
-with rapid cycling
-bipolar 2
-cyclothymia
-unipolar disorders
-major depression
-1. With melancholic features
-2. With spychotice features
-3.etc
-dysthymia
Term
Major Depression
(intro card)
Definition
Term
symptoms
(of maj dep)
Definition
emotional, cognitive, motivational, somatic ...

 Note: Symptoms may influence each other resulting in vicious cycle
Term
emotional symptoms
Definition
– one of these IS necessary
 sadness
 loss of interest and/or pleasure (mask depression…)
Term
cognitive symptoms
Definition
 negative view of self, esp. low self esteem
 self-blame and/or guilt
 pessimism/hopelessness (regarding the future- will things ever get better? P milder than H)
 difficulty making decision
 poor concentration (all the self-absorbtion makes it difficult)
Term
motivational symptoms (behaviors)
Definition
 lack of response initiation (difficulty getting started)
 psychomotor retardation (move and talk slower…)
 psychomotor agitation (more nervous/anxious- fidgeting, pacing…)
Term
somatic symptoms
Definition
 disturbance of appetite
 loss of appetite
 Increased appetite
 sleep disturbance
 insomnia (sometimes with shortening of REM latency- doesn’t go as long or as deep into REM, less likely to wake up feeling rested- more likely to occur in people whose depression was not precipitated by negative life events (suggests underlying biological process))
 hypersomnia
 reduced sex drive
Term
major depression VS dysthymia
Definition
Major depression:
-higher severity- 5 0f 9 sxs
-shorter duration- 2wks or longer
-reaction to stressor (later more sudden onset)
vs.

Dysthymia:
-lower severity- 3 0f 7
-longer duration- 2 yrs or longer, can’t be sx-free for longer than 2 mo
-Characterological (seems more like the dep is the person’s personality) (with earlier, more gradual onset)

note: not mutually exclusive, can have both (double depression)
Term
Differential Diagnosis
Definition
-substance-induced mood disorder (result of something they’re on…)
-need to consider whether depression is “primary “ problem or “secondary” to something they already have (OCD- major dep is byproduct of the obsessions/compulsions)
Term
major dep. disorder “specifiers” (subgroupings)
Definition
chronic, melancholic, psychotic, seasonal pattern, postpartum ...
Term
chronic
(subgrouping)
Definition
- >2 yrs
Term
with melancholic features
(subgrouping)
Definition
(‘endogenous depression’) – suggests biological factors
 loss of pleasure (unreactive to positive events in life) (anhedonia- inability to experience pleasure)
 unresponsive to good events (vs reactive depression)
 phys sxs:
 early a.m. wakening
 worse mood a.m.
 significant wt loss (more likely people to eat less- food isn’t yummy anymore)
▪psychomotor retardation or agitation
-more likely to respond to somatic therapy
Term
with psychotic features
(subgrouping)
Definition
(delusions, hallucinations)
-must be mood-congruent (woman who believes she’s the devil- I’m responsible for all of the troubles on the earth, I’m the worst person in the world (hopelessness…) ; NOT mood-congruent- ‘they’re out to get me…’= paranoid delusion)
Term
with seasonal pattern
(subgrouping)
Definition
(a.k.a. Seasonal Affective Disorder)
-dep increases during times of the year when sunlight decreases; higher the depression, higher the latitude
-unique sxs:
-hypersomnia, overeating (esp carbs), gain weight, fatigue
Term
DSM-IV of SAD
Definition
-at least 2 episodes in past 2 yrs that begin and end at the same time of year (have to be seasonal)
-no non-seasonal episodes in past 2 yrs
-seasonal episodes > nonseasonal episodes across lifetime
-not due to seasonal stressors (if Dec is anniversary of family dying in car crash, not SAD)
Term
with postpartum onset
(subgrouping)
Definition
-about 10% of mothers(50-80% experience ‘baby blues’)
-onset: begins within 4 weeks of birth of child – has to meet major dep standards
-sxs similar to MDD
-are women at greater risk for dep during postpartum period? –no, study: compared women who had just give birth to a baby and women who were matched in age and SES who had not just had a baby and the both had equal rates of getting depression
Term
epidemiology: modernity and depression
Definition
‘being down is on the rise’
Term
epidemiology: lifetime prevalence by age
Definition
18-24 yrs.
Born c.1960
N=1397 25-44 yrs.
Born c.1945
N=3722 45-64 yrs.
Born c.1925
N=2351 >65 yrs.
Born c.1910
N=1654
Means (across 3 major cities) 5.4% 8.6% 4.5% 1.3%
-^people who are 40 yrs younger have about 4x prevalence of depression (what will happen with 18-24yrs are 50 years old? –dep rates will be higher)
Term
epidemiology: 12 month prevalence
Definition
Age range 12 mo. prev.
15-24 1.67
25-34 1.32
35-44 1.35
45-54 1.00
Term
increasing suicide rates among youth
Definition
(not just younger people more willing to admit they’re depressed and old people trying to avoid stigma, but younger people are showing depression behaviorally = suicide)
– more teens die from suicide than other diseases combined (cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, chronic lung disease)
Term
old order Amish
Definition
-stress is lower in this culture
- tend to be happier than ‘we’ are; have about 1/5th the rate of depression compared to what we have (biological depression rates are the same- not just ‘hiding’/not owning up to their dep sxs)
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