Psychology 2320A/B Lecture Notes - Lecture 8: Major Depressive Disorder, Panic Disorder, Bipolar Disorder
29 Apr 2018
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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 extealizig 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 nothig ualitatiely diffeet ith ppl of depessio it’s ot you eithe you hae o do’t hae… it’s a otiuu
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)
find more resources at oneclass.com
find more resources at oneclass.com
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…depessio s aloholis)
– 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…ealy 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
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Children can and do meet for depression w/ and w/out exte(cid:396)(cid:374)alizi(cid:374)g (cid:271)eh"(cid:396) 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) Lecture 8- depression: 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: 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. 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)
