Morris mood as frame of mind
valence and arousal dimensions
activated, pleasant, deactivated, unpleasant
3 symptoms clusters
mood/affective
cognitive/behavioural
somatic/neurovegetative
Depressive episode DSM-5-TR
- 5+ in same 2W period; change from previous functioning; at least one either loss of interest or pleasure: depressed mood by subjective/observation report; diminished interest/pleasure; significant weight and appetite change; insomnia or hypersomnia; psychomotor agitation/retardation; fatigue; worthlessness; concentration difficulties; suicidal ideation
- significant distress or impaired functioning
- not from substance/ other medical condition
MDD DSM-5-TR
- depressive episode
- at least one of these not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, schziophrenia spectrum or other psychotic disorder
- never been a manic/hypomanic episode
persistent depressive disorder DSM-5-TR
- depressed mood for most of day and most days for at least 2 years; subjective and observation
- presence of 2+: poor appetite/overeating; insomnia/hypersomnia; low energy/fatigue; low SE; poor concentration; hopelessness
- never been without symptoms for more than 2MO at a time
- MDD criteria continuously present
- never been a manic/hypomanic episode
- not better explained by schizophrenia/psychotic disorders
- not attributed to substance/medical condition
- distress or impaired functioning
serotonin in depression
lowered serotonin levels via tryptophan depletion causes transient symptoms of depression
neuroendocrine dysfunction
HPA axis dysfunction- cortisol oversecretion
Schema
structure for screening, coding and evaluating the stimuli that impinge on organism
schemas in depression: negative triad
negative views of the world, self and future
hopelessness theories
key role of attributional style: global/specific; stable/unstable; internal/external
Hopelessness: attributions of negative events are global, stable, external
two-hit model
effects of childhood adversity and life stress on depression development
depression can result from two separate stressors: first pre-puberty and second during adulthood
SSRIs
increase serotonin in synaptic cleft by decreasing reuptake by presynaptic neurons
SNRIs
increase serotonin and noradrenaline in synaptic cleft by decreasing reuptake
MAO inhibitors
blocks the enzyme MAO which breaks down norepinephrine, serotonin and dopamine
ECT
passing an electric current 70-130V through brain
TMS
rTMS over prefrontal cortex
DBS
direct stimulation of brain sites; best tested in subgenus cingulate cortex
