Term
|
Definition
episode
– Depressed mood
– Anhedonia – loss of pleasure or interest in things
– Cogni>ve symptoms (e.g., worthlessness and
indecisiveness)
– Physical symptoms (e.g., disturbances in sleep, appe>te,
energy level)
– Symptom dura>on for diagnosis = 2 weeks
– Dura>on of untreated episode — 4 to 9 months |
|
|
Term
|
Definition
•– Exaggerated ela>on, joy, euphoria, or irritability
– 1 week, or less
– Cogni>ve symptoms (e.g., flight of ideas, grandiosity)
– Physical symptoms (e.g., decreased sleep, hyperac>ve, rapid speech)
• DSM-5 includes an emphasis on these changes in ac6vity and energy
– Dura>on of untreated episode = 3 to 6 months |
|
|
Term
|
Definition
Major depressive disorder, single episode
– no mania
• Major depressive disorder, recurrent
– 4 episodes (life>me)
– Dura>on—4 to 5 months |
|
|
Term
| Major depressive disorder |
|
Definition
chronic
– now classified as persistent depressive disorder |
|
|
Term
|
Definition
– now classified as persistent depressive disorder
– Milder symptoms, but more chronic
– 2+ years |
|
|
Term
Criteria for Depressive Disorders
Symptom Specifiers |
|
Definition
– Psycho>c
– Catatonic – absence of movement
– Melancholic
– Atypical - Oversleep, overeat, weight gain, anxiety
– Postpartum
– Suicidality
– Mixed symptoms
– With anxious distress |
|
|
Term
|
Definition
–Onset 30 years old for depression
– Dysthymic disorder may last 20 to 30 years
• Course
– Longitudinal course
– Seasonal paZern
• Seasonal affec>ve disorder (SAD)
– CBT and Phototherapy - effec>ve |
|
|
Term
|
Definition
Alterna>ng major depressive and manic
episodes
• Single manic episode
• Onset age 15-18
• Recurrent
– Symptom-free for 2 months |
|
|
Term
|
Definition
Alterna>ng major depressive and hypomanic
episodes
• Onset age 19-22
• 10 to 13% of cases progress to full Bipolar I
disorder |
|
|
Term
|
Definition
• Alterna>ng manic and depressive episodes
– Less severe
–Onset = age 12 or 14
– Lifelong
– Female>Male
– Risks for Bipolar I/II
• Less than half go on to develop bipolar disorder. |
|
|
Term
| Prevalence of Mood Disorders |
|
Definition
• Children and Adolescents
– Misdiagnosis (ADHD and Conduct disorder)
• Older adults
– 14% to 42% of nursing home residents
• Comorbidi>es
– GAD and panic disorder (33%), alcohol (33%)
• Across cultures
– Symptom presenta>on may differ |
|
|
Term
| Causes of Mood Disorders: Biological |
|
Definition
Familial and Gene>c Influences
– Family Studies - 2-3x higher in rela>ves of probands
– Twin Studies—iden>cal twins are 2-3x more likely than fraternal
• Bipolar: iden>cal 66.7%, fraternal 18.9%;
• Unipolar: iden>cal 45.6%, fraternal 20.2%
– Higher concordance with higher symptom severity
• NeurotransmiZer Systems
– The “permissive” hypothesis –
• Serotonin
• Norepinephrine
– Mania
• Dopamine |
|
|
Term
Causes of Mood Disorders:
Psychological |
|
Definition
• Stressful life events
• Learned Helplessness (Seligman)
• Depressive AZribu>onal Style
– Internal
– Stable
– Global
• Sense of hopelessness
– Pessimism- Before or a@er symptom onset?
• Depressive Cogni>ve Triad |
|
|
Term
| Treatment of Mood Disorders |
|
Definition
• Changing the chemistry of the brain
– Medica>ons
– ECT
– Psychological treatment |
|
|
Term
An>depressant Medicatons
Tricyclics |
|
Definition
Tricyclics (Tofranil, Elavil)
– Frequently used for severe depression
– Block reuptake/down regulate
• Norepinephrine
• Serotonin
– 2 to 8 weeks to work
– Many nega>ve side effects
– Lethality |
|
|
Term
Antidepressant Medications
Monoamine Oxidase (MAO) Inhibitors |
|
Definition
– Block MAO
– Higher efficacy than tricyclics
– Fewer side effects
– Interac>ons can lead to severe hypertensive
episodes and occasionally death
• Foods (e.g., cheese, red wine, beer)
• Medicines (e.g., some cold medica>ons)
– Selec>ve MAO-Is - short ac>ng, and do not
interact nega>vely with tyramine |
|
|
Term
An>depressant Medica>ons
Selec>ve Serotonin Reuptake Inhibitors |
|
Definition
– First treatment choice
– Block presynap>c reuptake
– No unique risks
• Suicide or violence
– Many nega>ve side effects
• physical agita>on, sexual dysfunc>on or low desire,
insomnia, and gastrointes>nal upse |
|
|
Term
|
Definition
• Mood-stabilizing drug
• Common salt
• Primary treatment for bipolar disorders
• Unsure of mechanism of ac>on
• Narrow therapeu>c window
– Too liZle—ineffec>ve
– Too much—toxic, lethal |
|
|
Term
|
Definition
• Electroconvulsive Therapy (ECT)
– Brief electrical current
– Temporary seizures
– 6 to 10 treatments
– High efficacy
• Severe depression
• 50% not responding to meds will get beZer
• Few side effects
• Relapse is common |
|
|
Term
Psychological Treatment of Mood
Disorders |
|
Definition
Cogni>ve Therapy
– Iden>fy and correct errors in thinking
• Behavioral therapy
– Increase opportuni>es for reinforcement from the
environment
• Interpersonal Psychotherapy (IPT)
– Address interpersonal issues in rela>onships
• Combined treatment
– More research is needed |
|
|
Term
| Types of suicide (Durkheim) |
|
Definition
Altruis6c suicide is socially or familially sanc>oned (e.g., to
avoid dishonor to self or family).
– Egois6c suicide is suicide caused by disintegra>on of social
support.
– Anomic suicide occur following some major disrup>on in
one's life (e.g., sudden loss of a high pres>ge job).
– Fatalis6c suicide is related to a loss of control over one's
des>ny (e.g., mass suicide of Heaven’s Gate cult). |
|
|
Term
The Influence of Psychological and Social
Factors |
|
Definition
50% of the leading causes of death in the
U.S. are linked to behavioral / lifestyle
paEerns
– Smoking
– Poor eaRng habits
– Lack of exercise
– Insufficient injury control
• Seatbelts |
|
|
Term
Stress Response & General AdaptaRon
Syndrome |
|
Definition
– Phase 1 – Alarm response
– Phase 2 – Resistance
– Phase 3 – ExhausRon |
|
|
Term
|
Definition
SNS acRvaRon
• Neuromodulators and neuropepRdes
– CRF
• HPA axis acRvaRon
– CorRsol
• Limbic system acRvaRon
– Hippocampus
• Chronic stress may damage cells in the
hippocampus, thus maintaining the HPA loop
– PTSD
– DemenRa |
|
|
Term
|
Definition
– Humoral
– Cellular
• FuncRon—idenRfy and eliminate
anRgens
– Leukocytes (WBC) |
|
|
Term
|
Definition
Macrophages
• Lymphocytes
– B cells (humoral branch) — produce anRbodies
• Immunoglobulins - anRbodies
• Memory
– T cells (cellular branch)
• Killer - directly destroy anRgens
• Helper
• Suppressor
• Memory - faster response next Rme anRgen is introduced |
|
|
Term
| Cardiovascular Diseases: Hypertension |
|
Definition
• Associated Features
– Prevalence = 27.6% (age 35 to 64)
– African Americans = 2x greater risk
– Risks:
• Salt
• Fluid volume
• SympatheRc arousal
• Stress level
• Expressed anger
• HosRlity |
|
|
Term
Cardiovascular Diseases: Coronary Heart
Disease |
|
Definition
• Coronary Heart Disease (CHD)—blockage
of arteries supplying blood to the heart
muscle
– Angina pectoris
– Atherosclerosis
– Ischemia
– Myocardial infarcRon |
|
|
Term
| Stanford Three Community Stud |
|
Definition
CHD risk reducRon
– Three enRre, similar communiRes
• No intervenRon
• Media blitz
• Media blitz plus face-to-face intervenRon
– Highest benefit |
|
|
