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37. Depression 1. Clinical Picture.doc

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University of Toronto St. George
Mac Burnham

DEPRESSION 1: Clinical Picture / Biopsych Perspective Read: Carlson (Chapter 16), Warsh and Li, Blier and de Montigny, Kennedy et al. Outline: Terminology / Traditional Terminology Depression (Clinical Depression) Bipolar Disorder / Mania Causes Biopsychological Perspective TERMINOLOGY: “Mood Disorder” = usually depression (in some patients may alternate with mania) TRADITIONAL TERMINOLOGY  Neurosis (not split from reality) vs. Psychosis (split from reality) o Neurosis: Anxiety Disorders o Psychosis: Organic vs. Functional  Organic (clear brain abnormality): • Dementia Senex: Alzheimer’s  Functional (no clear brain abnormality): • Dementia Praecox: schizophrenia • Melancholia: depression CLINICALSYNDROME: DEPRESSION Also: Major/Clinical depression 1) A “psychosis”(?)(some patients, not all, hallucinate; “affect” divorced from reality) “a disorder of affect” (schiz: “a disorder of cognition”) 2) Very common: 10-20% of population, 3% hospitalized • Carlson: 3% of men; 7% of woman (women > men) (2X) th • Carlson: 4 leading cause of disability • Mayberg: main cause of disability in the young 3) Serious, disabling, long lasting sadness(2 weeks plus, may recur) • Potential for suicide (16% attempt) • Two patterns: chronic vs. cyclic depression 4) Types (terms): • Endogenous: depression that’s strongly biological • Reactive: depression triggered strongly by bad env. experiences • Monopolar: depression by itself • Bipolar: depression alternating with mania 5) Symptoms: Depression: sad, slow (move and talk slowly, “psychomotor slowing”), tired (no energy), negative self-image (unworthy, guilty; core cognitive symptom of depression), anhedonia (may be agitated rather than “slow”) Also: disorders in sleep (insomnia, early morning waking), eating, loss of interest in sex (just like chronic pain)  Symptoms may be constant or come in episodes 6) Onset: any time, more common in older people CLINICALSYNDROME : BIPOLAR DISORDER A “psychosis” (?) Less common: 1-2% of population (women = men) Serious, disabling  Potential for suicide (30% attempt) Types: with bipolar, depression is given. But two manic states  Mania: clearly out of control (bipolar 1)  Hypomania: person’s on a high for a few months and just doing really well (will likely go on to more serious forms of mania later in life) • Hy
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