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Lecture 8

Psychology 2320A/B Lecture Notes - Lecture 8: Major Depressive Disorder, Panic Disorder, Bipolar Disorder


Department
Psychology
Course Code
PSYCH 2320A/B
Professor
Elizabeth Hayden
Lecture
8

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Lecture 8- Depression
HISTORICAL OVERVIEW
Emil Kraepelin: father of modern psychiatric classification
1920: differentiated between schizophrenia and manic depression
Kraepelin described unipolar depression (MDD) and bipolar depression but considered these a
single disorder
Existence of childhood depression disputed through the 80s
Masked depression: depression in the form of somatic complaints, externalizing behavior
- children can and do meet for depression w/ and w/out extealizig eh’
DSM-5 DEFINITIONS: MAJOR DEPRESSIVE EPISODE AND MAJOR DEPRESSIVE DISORDER
For at least two weeks, 5 or more of these sxs are present, and at least one is #1 or #2:
#1: Depressed mood (can sub irritability in children/adol)
#2: Anhedonia (i.e., loss of interest/pleasure)
Appetite/weight change
Sleep change
Psychomotor change
Fatigue or loss of energy
Feelings of worthlessness/guilt
Poor concentration
Thoughts of death/suicidality
Major depressive disorder (MDD) = at least one MDE
- like panic disorder, need to know panic attack. This case, need to know depressive episode to know depression
DSM-5: PERSISTENT DEPRESSIVE DISORDER
In children & adolescents:
Depressed or irritable mood present for at least 1 year
+ 2 other symptoms (e.g., sleep & appetite changes, low energy, low self-esteem, poor
concentration, hopelessness)
- instead: duration and severity about depression would be better instead of splitting into 2 different disorders
CATEGORY OR DIMENSION?
Elevated symptoms predict greater impairment, even when full criteria are not met for diagnosis
Elevated symptoms predict future diagnosis
Subthreshold depression is familial
Hence, depression appears to fall on a continuum and may be best conceptualized as a dimension
- there is nothig ualitatiely diffeet ith ppl of depessio it’s ot you eithe you hae o do’t hae… it’s a otiuu
PHENOMENOLOGY IN YOUTH
Children can and do meet adult criteria for depression
Depressive & related symptoms in childhood (actually look sad):
Somatic (physical) complaints, irritability, depressed appearance, poor self-esteem relatively
common
Anhedonia, hopelessness, hypersomnia, weight gain relatively uncommon
Depression in adolescence more closely resembles adult depression
- *depression in kids (before puberty) is different than adolescent with depression (more like adults)
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SEX/GENDER DIFFERENCES
NO consistent sex differences in childhood
Male children may be at slightly higher risk for depression
Adolescence (ages 12-14) is when 2:1 female:male difference emerges
Female preponderance is stable through adulthood
Sex difference found across different cultures
Why? (these following not valid reason)
Treatment-seeking
Reporting biases (men suck at remembering shit including depressive episode…ot a alid easo
Multiformity (same underlying casual factors is expressed diff whether f/m…depessio s aloholis)
Sex-linked genetic transmission (f/m diff genes)
Hormonal differences
Life stress (*men greater since soldiers, but women feel more stress over lil things than men)
Role/societal factors (men benefit more from marriage health and psychologically, not women LOL)
SECULAR CHANGES
Rates of depression appear to be on the rise in recent generations
Why?
Forgetting
Selective mortality
Increased awareness
Population increases
Social changes (more competition in life)
ASSESSMENT
Highest prev estimates of youth depression when self-report used
Maternal depression influences reports of child behavior problems
Increased child negative behavior
Partially due to maternal bias, partially to true differences
PREVALENCE
Prior to adolescence, MDD is relatively rare
Does depression exist in infancy?
Failure to thrive (undernutrition, psychomotor delay…ealy anifestation of MDD)
One study: 1% prevalence of MDD in very young children (preschool age)
Older children: estimates of MDD prevalence range from .2-5%
MDD prevalence by end of adolescence: 15-20%
Lifetime MDD in adulthood:
Males: 13%
Females: 22%
Chronic depression: 5.4% in adulthood; 3-5% in adolescence, .5-1.5% in childhood?
Bottom line: prevalence estimates approach lifetime rates by end of adolescence
- take home message: rare, pubertal development changes in social/biological, in adolescent: common prob
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find more resources at oneclass.com
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