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PSYC203 (40)

Part 2- L5.docx

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Gareth Treharne

Part 2- L5 Depression and suicide Depression L2 - Aetiology (the cause of a disease) o Genetic factors  46% concordance with MZ twins  20% concordance with DZ twins  Genes involved in the synthesis of serotonin from tryptophan and the transmission of serotonin at the synapse  Norepinephrine metabolism  Genes can influence affective of SSRI o Biological  Norepinephrine and serotonin implicated (associated) in cause of depression  Mood is result of interaction between both serotonin and norepinephrine systems  Also dopamine and acetylcholine  Limbic system is major brain area involved in depression o Sociocultural  Poor, ethnic minorities, poor social or marital support, divorce, separation, child abuse, neglect  Combination makes people more prone  Jobless, 11X more likely  Low income 10X more likely  Women – experience more responsibilities and lower life qualities than men.  Men more able to distract selves from depressing event than women - Explanation o Psychodynamic (Freud)  Similar to grieving  Regresses to oral stale as defence mechanism against overwhelming distress  Introjection × Direct their feelings of loved one into themselves × Anger > result of unresolved conflict × Pathological if long term o Behavioural  Operant learning processes  Low rate of positive social reinforcement > low mood  Behaviour results in sympathy and attention × Establish a further reinforcement schedule × Secondary gain- individual is rewarded for their depressive behaviours o Learned helplessness  Individual learns they are unable to control physical/social environment o Cognitive  Result of three key attribution processes × Internal/external  Did the outcome arise as a result of the person or the situation? × Stable/unstable  Will the result happen every time is it changeable or random? × Global/specific  Does the outcome occur in all situations or only in a specific instance? × “It’s my fault, it will always go wrong, and this is just typical life” - Treatment o Biological interventions  Antidepressants × Serotonin level  Tricyclic’s  14% of people will stop using because of side effects  SSRIs  Better than tricylic  56%/ 8% dry mouth  39%/8% constipation  SNRIs × Monoamine oxidase inhibitors (MAOI)  Improvement of 50% of people o Electroconvulsive therapy × Once weekly gradually to once monthly × 7% of people with ECT and antidepressants compared to 48% receiving only antidepressants relapsed o Psychological interventions × Cognitive therapy × Interpersonal psycho therapy Expressions - Belief that others would be better off if one were dead - Transient reoccurring thoughts of committing suicide - Concrete plans and means to commit suicide Variance in frequency, intensity and lethality of expressions Motivation - Perception of insurmountable obstacles - Intense desire to escape emotional pain - Desire to feel or to feel pain’ New Zealand - Epidemiology o In 2008- 512 self-inflicted deaths  73.% were male  1:5, women: men o In 2008- 365 died on roads  65.2% males o Maori youth suicide rate is higher than non-Maori. o Self-inflicted deaths are more common among males o Self-inflicted injury is more common among females o Age related differences o Distribution of suicide by mental disorder  30% of people who have committed suicide will have mood disorder  15% of people who have committed suicide have substance abuse  15% of people who have committed suicide will have schizophrenia  2% of people who have committed suicide won’t have a disorder  Not just depression which is associated w
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