Textbook Notes (380,846)
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PSYB32H3 (1,181)
Chapter 10

chapter 10

13 Pages
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Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

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Chapter 10: Mood Disorders: involve disabling disturbances in emotion and from the sadness of depression
to the elation and irritability of mania
Often associated with other psychological problems such as panic attacks, substance abuse, sexual
dysfunction and personality disorders
Depression: SIGNS AND SYMPTOMS
Depression is an emotional state marked by great sadness and feelings of worthlessness and guilt;
withdrawal from others and loss of sleep, appetite, sexual desire and interest and pleasure in usual
activities
Patients cant concentrate and cant take in what they read or what ppl say to them
They speak slowly after long pauses using few words and a low monotonous voice
Make complaints of somatic symptoms with no apparent physical basis
Symptoms and signs vary somewhat across the lifespan
People tend to emphasize somatic symptoms rather than emotional ones when they are being
evaluated in medical setting
Psychologizers: people who emphasize the psychological aspects of depression
Mania: SIGNS AND SYMTPOMS
Emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity,
talkativeness, flight of ideas, distractibility and impractical, grandiose plans
FORMAL DIANOSTIC LISTING OF MOOD DISORDERS
Major depressive disorders (MDD): diagnosis requires presence of 5 of the following symptoms for at least
two weeks; either depressed mood or loss of interest and pleasure must be one of the 5 symptoms
oSad, depressed mood, most of the day everyday
oLoss of interest and pleasure in usual activities
oDifficulties in sleeping (sleeping too much or too little)
oShift in activity level, becoming either lethargic (psychomotor retardation) or agitated
oPoor appetite and weight loss or increased in appetite and weight gain
oLoss of energy, great fatigue
oNegative self-concept, self-approach and self-blame, feelings of worthlessness and guilt
oComplaints or evidence of difficulty in concentrating, such as slowed thinking and indecisiveness
oRecurrent thoughts of death or suicide
Depression is continuous vs. Depression reflects taxonomic, categorical structure
Lifetime prevalence rates range from 5.2% to 17.1%; Current and lifetime prevalence rates are higher
among younger people than older people
www.notesolution.com
MDD two times more common in women than men; gender diff. Does not appear in preadolescent, but
emerges in mid-adolescence (age 14)
oWomen more likely than men to engage in ruminative coping: focus attention on their depressive
symptoms; men distract themselves by doing something that diverts their attention
oBrooding: moody pondering
ofemales and males differ in the stressors they experience; girls face more social challenges than boys
ovictimization is more common in women and perhaps it is exacerbated by related differences in
rumination
depression tends to be a recurrent disorder; 80% of those with depression experience another episode
and the average age # of episodes is 4
ppl with MDD who had certain coexisting personality disorders had significantly longer time to
remission of symptoms than did MDD patients w/o any personality disorder
kindling hypothesis: once depression has already been experienced, it takes relatively less stress to
induce a subsequent recurrence
oautonomy hypothesis: depression has become autonomous and no longer requires stress
osensitivity hypothesis: person has become sensitized to stress and even small amounts of stress are
sufficient to induce depression
Diagnosis of Bipolar Disorder
bipolar I disorder: involves episodes of mania or mixed episodes that include symptoms of both mania
and depression
oformal diagnosis requires presence of elevated or irritable mood plus three additional symptoms and
four if the mood is irritable
othe symptoms must be sufficiently severe to impair social and occupational functioning
increase in activity level at work, socially or sexually
unusually talkativeness; rapid speech
flight of ideas or subjective impression that thoughts are racing
less than the usual amount of sleep needed
inflated self-esteem; belief that one has special talents, powers and abilities
distractibility; attention easily diverted
excessive involvement in pleasurable activities that are likely to have undesirable consequences,
such as reckless spending
bipolar occurs less often than MDD with life prevalence rate of both I and II of about 4.4% of the
population in NCS-R
the age of onset is in the 20s and it occurs equally often in men and women
www.notesolution.com
among women, episodes of depression more common and episodes of mania less common than men
bipolar disorders tend to recur; more than 50% of cases have four or more episodes
violent behaviours can occur during severe manic episodes
people with BP lose insight into their condition and this can result in treatment resistance, financial
and legal difficulties, substance abuse and martial and occupational failure
HETEROGENEITY WITHIN THE CATEGORIES
heterogeneity: people with same disorder vary greatly from one another
mixed episode: experience full range of symptoms of both mania and depression everyday
bipolar II disorder patients have episodes of major depression accompanied by hypomania, a change in
behaviour and mood that is less extreme than a full-blown mania
some depressed people may be diagnosed as having psychotic features if they are subject to delusions
and hallucinations
presence of delusions appears to be a useful distinction among people with unipolar depression
depressed patients with delusions do not generally respond well to usual drug therapies for
depression, but they do respond favourably to these drugs when they are combined with the drugs
common to treat psychotic disorders
depression with psychotic features is more severe than depression without delusions and involves more
social impairment and less time b/w episodes
patients with depression may have melancholic features: specific pattern of depressive symptoms; they
find no pleasure in any activity and are unable to feel better even temporarily when something good
happens; their depressed mood is worse in the morning; they awaken about two hrs too early, lose
appetite and weight and are either lethargic or extremely agitated; respond well to biological
therapies; have comorbidity with anxiety disorders, more frequent episodes, and more impairment
catatonic features: motor immobility or excessive purposeless activity; present in both manic and
depressive episodes
postpartum depression: manic and depressive episodes occur within 4 weeks of childbirth
odepression, negative life events, lower socio-economic status, self-critical perfectionism are related to
depressive feelings of PPD
oadjustment disorders: bouts of depression or anxiety that stem from a stressful life event
ofathers with PD women reported greater levels if dissatisfaction with martial and family changes and
greater stress, especially in terms of work and economic pressures
omaternal prenatal depression affects fetus and the newborn including elevated fetal activity, delayed
prenatal growth, prematurity and low birth weight; they have elevated cortisol, lower levels of DA and
5-HT
seasonal affective disorder (SAD): patients symptoms varied in response to the changes in climate and
latitude in a manner that suggested that reduced exposure to sunlight was causing their depression
prevalence of SAD was 2.9%
www.notesolution.com

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Description
Chapter 10: Mood Disorders: involve disabling disturbances in emotion and from the sadness of depression to the elation and irritability of mania Often associated with other psychological problems such as panic attacks, substance abuse, sexual dysfunction and personality disorders Depression: SIGNS AND SYMPTOMS Depression is an emotional state marked by great sadness and feelings of worthlessness and guilt; withdrawal from others and loss of sleep, appetite, sexual desire and interest and pleasure in usual activities Patients cant concentrate and cant take in what they read or what ppl say to them They speak slowly after long pauses using few words and a low monotonous voice Make complaints of somatic symptoms with no apparent physical basis Symptoms and signs vary somewhat across the lifespan People tend to emphasize somatic symptoms rather than emotional ones when they are being evaluated in medical setting Psychologizers: people who emphasize the psychological aspects of depression Mania: SIGNS AND SYMTPOMS Emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity, talkativeness, flight of ideas, distractibility and impractical, grandiose plans FORMAL DIANOSTIC LISTING OF MOOD DISORDERS Major depressive disorders (MDD): diagnosis requires presence of 5 of the following symptoms for at least two weeks; either depressed mood or loss of interest and pleasure must be one of the 5 symptoms o Sad, depressed mood, most of the day everyday o Loss of interest and pleasure in usual activities o Difficulties in sleeping (sleeping too much or too little) o Shift in activity level, becoming either lethargic (psychomotor retardation) or agitated o Poor appetite and weight loss or increased in appetite and weight gain o Loss of energy, great fatigue o Negative self-concept, self-approach and self-blame, feelings of worthlessness and guilt o Complaints or evidence of difficulty in concentrating, such as slowed thinking and indecisiveness o Recurrent thoughts of death or suicide Depression is continuous vs. Depression reflects taxonomic, categorical structure Lifetime prevalence rates range from 5.2% to 17.1%; Current and lifetime prevalence rates are higher among younger people than older people www.notesolution.com MDD two times more common in women than men; gender diff. Does not appear in preadolescent, but emerges in mid-adolescence (age 14) o Women more likely than men to engage in ruminative coping: focus attention on their depressive symptoms; men distract themselves by doing something that diverts their attention o Brooding: moody pondering o females and males differ in the stressors they experience; girls face more social challenges than boys o victimization is more common in women and perhaps it is exacerbated by related differences in rumination depression tends to be a recurrent disorder; 80% of those with depression experience another episode and the average age # of episodes is 4 ppl with MDD who had certain coexisting personality disorders had significantly longer time to remission of symptoms than did MDD patients wo any personality disorder kindling hypothesis: once depression has already been experienced, it takes relatively less stress to induce a subsequent recurrence o autonomy hypothesis: depression has become autonomous and no longer requires stress o sensitivity hypothesis: person has become sensitized to stress and even small amounts of stress are sufficient to induce depression Diagnosis of Bipolar Disorder bipolar I disorder: involves episodes of mania or mixed episodes that include symptoms of both mania and depression o formal diagnosis requires presence of elevated or irritable mood plus three additional symptoms and four if the mood is irritable o the symptoms must be sufficiently severe to impair social and occupational functioning increase in activity level at work, socially or sexually unusually talkativeness; rapid speech flight of ideas or subjective impression that thoughts are racing less than the usual amount of sleep needed inflated self-esteem; belief that one has special talents, powers and abilities distractibility; attention easily diverted excessive involvement in pleasurable activities that are likely to have undesirable consequences, such as reckless spending bipolar occurs less often than MDD with life prevalence rate of both I and II of about 4.4% of the population in NCS-R the age of onset is in the 20s and it occurs equally often in men and women www.notesolution.com
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