What is persistent depressed disorder?
Less severe but long lasting symptoms than MDD. Less common but has earlier. Long casting nature can lead to MDD (70%. ) tends to become a personality trait. Also has an earlier onset (11-12 years of age)
What is disruptive mood regulation disorder?
This diagnosis was a response to over-diagnosis of BP among youth
① severe temper outbursts that are overreactions to situations
②chronica persistent irritable angry moved b/w those outbursts
③ overlap with ODD but odd kids have better emotional regulation.
4. low reliability due to lack f knowledge on how it may present
5. comorbidities
5. difficulty establishing DMDD as a discrete diagnosis
Define bipolar disorder.
Depression & manic episodes.
Define mood disorder
Mood disorders can be defined as poorly defined, persistent, extreme, ongoing poorly regulated emotions. Moods can vary from extreme unhappiness to hugh elation.
Types: BP AND MDD
Which age group experienced the highest rate of MDD from 2008 toi 2012?
12-17 and 18-25 while those above 26 had fairly stable rates
What is MDD?
It consists of the following characteristics for 2 weeks or more:
- irritable mood/depressed mood
- loss of interest/pleasure in activities
- distress and impairment in functioning
- other symptoms include but not limited to sleep disturbances, diff in concentrating and feeling worthless
-
How can we categorise the symptoms of depression?
MOOD:
1. dysphoria - general dissatisfaction or general uneasiness with life
2. anhedonia - loss ofpleasure or interest in activities
3. irritable mood - annoyance, temper outbursts, touchiness
PHYSICAL/SOMATIC:
1. Insomnia-hypersomnia
2. wright loss/weight gain
3. fatigue - loss of energy
4. feeling restless or slowed dowm
COGNITIVE
1. lack of concentration or ability to think
2. ideas of worthlessness and excessive guilt which an turn into delusions
3. indecisiveness
4. low-self esteem: if it is hinging to one particular aspect and if it takes a hit then its harmful
SOCIAL
1. Withdrawal
2. Co-rumination - dep ppl attract dep ppl and tend to openly talk about negative feelings. Such individuals tend to bond over shared negative feelings. This can exacerbate feelings
What are the 2 main characterizations that need to be present for an inovidual (atleast1) to be diagnosed?
- Loss/diminished of interest.
- Depressed/irritable mood most of the day, every day in almost all activities
what are specifiers for MDD?
They help in diagnosis or assessment of MDD
1. Severity ratings of mild/moderate/devere are determined with the help of the following:
- number of symotoms
- amount of symptom distress
- impairment in eceryday functioning caused by the symptoms
- In full or partial remission i.e if the person met criteria for MDD earlier and does not right now then are they depressed?
- sINGLE OR RECURRENT EPISODE - chronicity is determined in regards to whn did the 1st ep was experienced
- psychotic symptoms?? -delusion/hallucination
- anxious symptoms: feeling tense, restless
What kind of behaviours or symptoms should be expected in pre- pubescent ages
- Somber/tearful
- irritable
- withdrawal from social activities
- somatic complaints
- poor school peformance
- defiance/aggression
PDD was also known as ___
Dysthymia
What is double depressiom
presence of symptoms of both MDD and P-DD in a child
What are some of rsk factors of MDD?
- emotional reactivity - prevalent in preschoolers who are at higher risk of dperesssion. occurs even before an episode
- gender orientation: girls and non-binary are at a higher risk. Girls because of differences in limbic system activation when processing sadness, use more ruminative coping style.
- BIPOC youth face higher rates of depression but lower levels of treatment
What is the role of race and ethnicity in the in determining depression rates?
- higher rates of depression among women
- racial discrimination was the best predictor of depression explaining 25% variance
- less availability and uptake of discriminated groups despite higher prevalence
- 16% first nations youth experienced depression as compared to 8% canadian populations
What treatment has been successful in treating depression among youth?
- CBT
- Interpersonal psychotherapy for adoloscent depression - improving interpersonal functioning by enhancing communication skills in significant relationships has also helped
How many of those diagnosed receive help for depression? discuss medicated and non-medicated treatments
50% only
- very few recieve non-med treatments like environmental intervention and therapy
- mostly meds
Does depression lead to increased suicidality ?
Yes, however it is not the only determining factor of suicidal ideation. It increased chances of 1st suicide attempt among adolescents by 5 folds
- risk of suicide is accompanied by feelings of hopelessness, despair, helplessness about the future and how it will not improve
- depression exposes youth to most risk of committing suicide and double up during this stage however decline after 17-18 which can be attributed to brain maturation aiding in dealing beter with negative thoughts
Discuss the Columbia- suicide severity rating scale
Suicidal ideation categories or levels:
- Wish to be dead - lowest risk as peron has no plan or intent or method just an intent to be dead
- Non-specific active (somewhat) suicidal thoughts: no plan or intent but just thoughts about killing self
- Active suicidal ideation with any mehtods but no plans or intent to act : subject has thought of atleast 1 method durin assessment
- Acive suicidal idealtion without any specific plan but some intent to act
- still lacks a specific plans - Active suicidal ideation with specific plan and intent: thoughts on killing self with a method, intent and plan
*** cOUNSELLING PERSPECTIVE: non-specific need to inform or violate privacy unless plans are specific and dangerous
What is mania?
highly expansive and elated moods, inreased goal directed activity, feelings of euphoria(exaggerated sense of well being)
What do manic episodes consist of ??
- exaggerated sense of well-beig and elation
- increased goal-directed activity that might not make sense to normal people
- unusually elevated, expansive or irritable mood
- mood can shift quickly to anger especialy towards the people obstructing their plans or goals
- grandiose delusions
- psychotic features
What does the Youth Bipolar disorder present itself??
It has the follwoing charactersitics:
- irritability/rage
- overtalkative, sensitive, giddy
- grandiose delusions and beliefs
- sexual disinhibition
- unrealistic elevation in self esteem
- goal directed behavors: engaging in the same activity for multiple hpurs but on the contrary get distracted and restless very easily
What is the controversy about the youth bipolar disorder?
- it occurs infrequently which contrasts with the major leap and overdiagnosis over the past decades
- overlaps symptoms with certain childhood disorders like ADHD
- lack of inter-rater reliabilty due to a lot of variability or differences among episodes
- mood swing, irritaility, aggression are common among children in general his can lead to over or misdiagnosis
- lack of diagnostic reliabilty
What are the different kinds of depression?
bipolar 1: at least one episode of mania throughout lifetime
bipolar 2: atleast one ep of hypomania in combination to one or more MDD
3. cyclothymic disorder: persistent hypomania and depressive symptoms or low grade depression. Less severe and neither meet full criteria
4. Mixed features: wherein either mania or MDD dominates and the other is commonly subthreshold symptoms.
