Lecture 6: Mood Disorders

Question 1

What is mania?

Answer 1

Characteristics by intense and unrealistic feelings of excitement and euphoria or irritability

Question 2

What is unipolar depressive disorder?

Answer 2

A person experiences only depressive episodes

Question 3

What is bipolar disorder?

Answer 3

A person experiences both depressive and manic episodes

Question 4

What is a depressive episode?

Answer 4

When a person is markedly depressed or loses interest in formerly pleasurable activities for at least 2 weeks

Question 5

What is a manic episode?

Answer 5

Markedly elevated, expansive or irritable mood for at least 7 days

Question 6

What is a hypomanic episode?

Answer 6

Abnormally elevated, expansive or irritable mood for at least 4 days; the person must also have at least 3 other symptoms similar to those involved in mania

Question 7

How is the rate of unipolar depression related to SES?

Answer 7

Inversely related

Question 8

What is the diagnosis baseline of Major Depressive Episode?

Answer 8

5+ of the following symptoms, present for >2 weeks (most of the day nearly every day), causing impairment/distress, must include (1) or (2)
1. Low mood
2. Loss of interest or pleasure
3. >5% loss of body weight or decrease/increase appetite nearly everyday
4. Sleep disturbance
5. Agitation or feelings of being slowed down
6. Loss of energy
7. Feelings of worthlessness, low self-esteem, tendency to feel guilty
8. Loss of ability to concentrate
9. Thoughts of death/suicide

Question 9

Relapse vs Recurrence

Answer 9

Relapse happens when symptoms return quickly after treatment, meaning the person hasn’t fully recovered. Recurrence is when a person has been well for a long time but then develops a new episode of depression later on.

Question 10

What is another name for Persistent Depressive Disorder?

Answer 10

Dysthymia

Question 11

2 requisites for Persistent Depressive Disorder diagnosis

Answer 11

1. Depressed mood for most of the day, for more days than note, for at least 2 years
2. Never been without symptoms for more than 2 months at a time

Question 12

What is double depression?

Answer 12

Moderately depressed on a chronic basis but undergo increased problems from time to time, during which the person also meets the criteria fro a major depressive episode

Question 13

What is premenstrual dysphoric disorder?

Answer 13

When a woman faces at least five symptoms in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses

Question 14

What are 3 causal biological factors in unipolar mood disorders?

Answer 14

1. Genetics
2. Neurochemical and neurobiological factors
3. Sleep and other biological rhythms

Question 15

Independent vs Dependent Life Events

Answer 15

Independent life events are events that happen on their own, like a sudden loss. Dependent life events occur as a result of one’s behaviour.

Question 16

What is neuroticism/negative affectivity?

Answer 16

A personality trait that makes a person more sensitive to negative stimuli or emotions.

Question 17

What is early adversity as a diathesis?

Answer 17

Experiencing difficulties or challenges early in life can make someone more vulnerable to depression later in life.

Question 18

What is the behavioural theory of unipolar mood disorder?

Answer 18

Depression may occur when a person’s actions no longer lead to positive reinforcement (reward or pleasure) or when there is an increase in negative reinforcement (more unpleasant experiences or punishments). But not proven by research yet.

Question 19

What is Beck’s Cognitive Theory?

Answer 19

• Beck believed that negative thoughts (cognitive symptoms) are often the first signs of depression and can cause mood symptoms, rather than mood problems causing negative thinking.
• Depression is linked to rigid, extreme and unhelpful believes about oneself, the world or the future (Negative Cognitive Triad)
• When these negative beliefs are triggered by a stressed or depressed mood, they lead to automatic negative thoughts, which reinforce the depression

Question 20

What is rumination?

Answer 20

Rumination is when someone repeatedly and passively focuses on their negative thoughts or problems. People who have a negative thinking style are more likely to ruminate and develop depression because they dwell on distressing thoughts rather than taking action to resolve them.

Question 21

What are the 5 elements of Beck’s Unified Model of Depression?

Answer 21

1. Early Experiences
2. Genetic Risk
3. Biological Stress Reactivity
4. Information Processing Biases
5. Negative Cognitive Triad

Question 22

What is cyclothymic disorder?

Answer 22

The repeated experience of hypomanic symptoms for a period of at least 2 years

Question 23

What is a mixed episode in Bipolar I disorder?

Answer 23

Symptoms of both manic and major depressive episodes for at least 1 week, either intermixed or alternating rapidly every few days

Question 24

Difference between Bipolar I and Bipolar II

Answer 24

Bipolar I has full mania, Bipolar II has hypomania (less intense). Bipolar II typically has worse depression than Bipolar I.

Question 25

5 causal factors in bipolar disorder

Answer 25

1. Genetic Influences 2. Neurochemical Factors 3. Hormonal Factors 4. Neuroanatomical Factors 5. Sleep and other biological rhythms

Question 26

What was the evolution of antidepressants?

Answer 26

1950s - MAOIs (monoamine oxidase inhibitors) 1960s - TCAs (tricyclic antidepressants) Now - SSRIs (selective serotonin re-uptake inhibitors)

Question 27

How long do antidepressants take before working?

Answer 27

3-5 weeks

Question 28

How many percent of patients do not respond to the first drug prescribed?

Answer 28

Around 50%

Question 29

How is a relapse caused?

Answer 29

Stopping the medication when symptoms have improved

Question 30

What is lithium commonly used to treat?

Answer 30

Bipolar Disorder. For people that don't respond well to lithium, can use anticonvulsants (drug used to treat seizures)

Question 31

For whom is electroconvulsive therapy used for?

Answer 31

Patients who are severely depressed and may be at an immediate risk of suicide

Question 32

What is Transcranial Magnetic Stimulation??

Answer 32

Uses magnetic pulses to stimulate specific areas of the brain. More effective than antidepressants, with fewer side effects compared to ECT.

Question 33

What is deep brain stimulation?

Answer 33

Used for people with severe depression who haven't responded to other treatments. Involves implanting an electrode in the brain and using an electrical current to stimulate specific areas of the brain.

Question 34

What is bright light therapy?

Answer 34

Used for seasonal affective disorder (depression related to changes in seasons, usually in winter), but shown to be effective for nonseasonal depression as well. Uses light to regulate mood.

Question 35

What is CBT work?

Answer 35

Focuses on current problems and helps people identify and evaluate their negative thoughts and dysfunctional beliefs. Teaches people how to challenge and change these negative thought patterns.

Question 36

What is Behavioural Activation Treatment?

Answer 36

A newer treatment that focuses on increasing positive activities.

Question 37

What is interpersonal therapy?

Answer 37

Focuses on current relationship issues, helping people understand and change unhealthy interaction patterns.

Question 38

Is there a genetic link when it comes to suicide?

Answer 38

The concordance rate for suicide is about three times higher in identical twins compared to fraternal twins, suggesting a genetic link.

Question 39

What is the serotonin function in relation to suicide?

Answer 39

Suicide victims often have changes in serotonin function, with reduced serotonin activity, which may be linked to depression and suicidal behaviour.

Question 40

What is executive function impairments with regard to suicide?

Answer 40

People who attempt suicide show significant impairments in executive function (such as decision-making, planning and impulse control).