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Lecture 6

PSYB32-lecture 6.docx

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Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

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PSYB32-lecture 6  Major depressive disorder- diagnosed by having five of the symptoms on the first two slides for at least two weeks; research shows that when compared groups that don’t have these symptoms for two weeks but a different amount of time or amount of symptoms, the results are the same; depressed mood or anhedonia (loss of pleasure) have to be one of those five symptoms; the prevalence is incredibly variable (5.7 % to 17.1%) probably due to inter rater reliability; one year prevalence is about 6.7%; two times more common in women than in men because of the ruminative coping hypothesis (more insightful, closer to their emotions), men drink at bars, hang out with friends, play sports, etc.); one of the leading causes of disability, 80% of patients with major depressive disorder will experience another episode; in one’s lifetime, most will experience about 4 bouts with the disorder; major depressive episodes last 3- 5 months thus can interrupt a person’s livelihood; DSM uses the word chronic if the condition lasts more than two years; first episode follows some sort of stressful life event; subsequence bouts will be caused by events that are even less stressful (punch-drunk analogy);  Bipolar I disorder- patient will experience full blown symptoms of a manic episode, but will also suffer from depression as well; highest of the highs and lowest of the lows; according to the DSM, two of the symptoms that must be present are at least an elevated or an irritable mood present (so either one or the other), plus three additional symptoms out of the list and the next slide; if there is no elevated mood but only an irritable mood then the DSM requires four of these symptoms to be present; the key is that it must disable the person with respect to their social or occupational functioning; still based in reality (manic episode different from psychotic episode); lifetime prevalence is4.4 %; age of onset is in the early 20s; equal gender incidence, however there is a difference in the symptoms they experience (women have more depressive episodes while men have more manic episodes); about 50% will experience a relapse in their symptoms mainly because when person is in a manic state, they have little insight into their illness, and secondly a lot of people with the disorder love the highs (manic); co morbidity is often quite high, typically because they will use some sort of illicit substances to even themselves out (more so in the depressive state);  Heterogeneity within the Categories  Mixed episodes- where bipolar person experience a full range of symptoms that will satisfy both a major depressive disorder and bipolar disorder everyday; they tend to fluctuate between incredibly depressed to incredibly manic almost everyday; more disability and much more difficult to treat  Hypomania (Bipolar II)- person will have episodes of major depression with hypomania (hypo means smaller or less severe bout of a manic state; more qualitative); more depressed than manic  Mood specifiers- specify something about their disorder that is specific to that person; psychotic features- person is suffering from depression or a bipolar disorder and they present full-blown delusions, or hallucinations; treated differently by getting both types of medication and these patients are far more disabled; melancholic features- type of depression that presents with a specific cluster of symptoms that includes loss of pleasure in things that they previously enjoyed, worse in the mornings than throughout the rest of the day, early risers, lose their appetite and therefore lose weight, either lethargic or extremely agitated, more treatment resistant and also experience more disability; catatonic features- quite rare these days, motor immobility; won’t be able to move freely or on command, used to see it with schizophrenic patients and can happen in people with mood disorders; seasonal qualifiers- when the bout of typically depression has some sort of relationship with the onset and the specific season of the year, reduction of sun light causes people to become more depressed for neuro-chemical reasons  Postpartum depression (PD)- type of qualifier that can be added to someone who might meet diagnostic criteria for a major mood disorder; mothers after giving birth within four months and present symptom logy of depression or bipolar disorder would meet diagnostic criteria for PD;  If symptom logy persists after two years then we call it a chronic mood disorder and there are different diagnostic labels when this happens: cyclothymic disorder or dysthymic disorder- symptoms are not severe enough to meet diagnostic criteria for a major depressive disorder or a bipolar disorder, so think of these as miniature versions of both that last a long time  Cyclothymic disorder: frequent periods of depressed mood and hypomania, patients usually have paired symptoms meaning that when they are feeling hypomanic they may have a bloated self-esteem, sleeping hardly at all and when they are depressed they feel worthless or no self- esteem, sleep a great deal of time; socially as well; lasts more than two years but not severe enough to cause any sort of disability in their real world; 2.5% prevalence for both cyclothymic and dysthymic disorders  Dysthymic disorder: miniature version of depression; someone who is chronically depressed; must be depressed more than half the time for at least two years; not significant enough to cause disability in their lives;  Double depression is when they experience dysthymia and at certain points meet criteria for major depressive disorder; continuous state of depression with no relief at any point in time; far more difficult to treat than simply just one of the above mentioned disorders  Very rare for a person with a psychological disorder, particularly depression, to psychologize the reason for their depression; in other words, most of them will
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