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Mood disorders: Depressive Disorders:
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DMDD- Disruptive Mood Dysregulation Disorder
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MDD- Major Depressive Disorder
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Persistent Depressive Disorder
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Premestrual Dysphoric Disorder
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(A) Disruptive Mood Dysregulation Disorder (MDD): Young [blank_start]children[blank_end] only
-severe & frequent [blank_start]temper tantrums[blank_end] interfere with ability to function at home, school, with friends
-usually more likely to develop problems with depression or anxiety in adulthood
Symptoms include:
-severe temper outbursts at least 3 times a week
-sad, irritable, or angry mood almost everyday
-reaction is bigger than expected
-child must be at least [blank_start]6[blank_end] years old
-symptoms begin before age 10
-symptoms are present for at least [blank_start]1[blank_end] year
-child has trouble functioning in more than 1 place
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children
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adults
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youths
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temper tantrums
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feelings of sadness
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feelings of pain
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feelings of anger
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6
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5
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7
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3
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1
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2
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3
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6 months
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(B) Major [blank_start]Depressive[blank_end] Disorder (MDD):
5 + symptoms in a 2 week period
1. reports of feeling depressed or sad most of day
2. loss of [blank_start]interest[blank_end] or ability to derive pleasure
3. significant weight loss (appetite)
4. difficulty [blank_start]sleeping[blank_end]
5. slowed down or agitated throughout day
6. feeling fatigued or a loss of energy
7. feelings of worthlessness (guilt)
8. difficulties concentrating
9. thoughts of death or [blank_start]suicide[blank_end]
significant distress or impairment in functioning
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Depressive
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interest
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sleeping
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suicide
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episodes usually last 6-9 months (severe cases -psychotic features)
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lifetime prevalence: 12% of Canadian adults (female > male 2:1)
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at least 50% have repeated occurrences
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most frequently comorbid with Bipolar
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Risk factors for MDD:
*[blank_start]Age[blank_end] (initial onset more common among younger adults)
*[blank_start]SES[blank_end]
*[blank_start]Marital[blank_end] Status (separated, divorced, higher risk)
*Aboriginal Status
*[blank_start]Gender[blank_end] (15-64 yrs old female > male)
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Age
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ses
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old age
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SES
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age
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marriage
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Marital
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indian
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Gender
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aboriginal
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[blank_start]Seasonal[blank_end] Affective Disorder (SAD):
female > male ; young adults
Symptoms:
-increased [blank_start]appetite[blank_end]
-weight gain
-greater need for sleep
WHY:
-biological rhythm disturbances (melatonin)
-serotonin [blank_start]deficiencies[blank_end]
Treatment: [blank_start]phototherapy[blank_end] (60-90% will respond)
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Seasonal
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Situational
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Seasons
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appetite
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decreased appetite
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feelings of worthiness
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phototherapy
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talk therapy
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hypnotism
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deficiencies
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increases
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levels higher
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(C) [blank_start]Persistent[blank_end] Depressive Disorder:
-less severe + more chronic
Symptoms:
-change in appetite
-not enjoying things previously enjoyed
-sleep disturbances
-loss of concentration
-persists for at least [blank_start]2[blank_end] years
*both dysthymia & MDD at same time is possible
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Persistent
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Seasonal
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Predictable
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2
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1
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3
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4
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Diagnostic Criteria for Manic Episode:
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mood abnormally and consistently elevated, expansive or irritable for at least 1 week
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during mood being elevated, 3 or more are present:
1. excessive self-esteem
2. less need for sleep
3. more talkative than usual
4. thoughts are racing
5. easily distracted
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increase in behaviour aimed at achieving goal
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impulsive acts aimed at increasing feeling of pleasure (e.g. shopping)
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Diagnostic Criteria for Hypo-manic Episode:
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for at least 4 days, nearly everyday
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less severe symptoms, change in functioning, not marked impairment
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more severe symptoms
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impaired functioning
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[blank_start]Bipolar[blank_end] Disorder:
-rare to experience episode of mania without accompanying depression at some point in life
-depressions last longer than the manic episode
-between episodes, may have [blank_start]normal[blank_end] mood, or may have periods of dysthymic symptoms
-Less common vs MDD- female= male
*Specifier- rapid cycling- 2+ full cycles of mania & depression in 1 year
Note- respond [blank_start]less[blank_end] well to medications
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what is Cyclothymic Disorder?
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longstanding pattern of alternating mood episodes that do not meet the criteria for MDD or manic episode
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duration of at least 2 years (1 for teens & children) with recurrent periods of mild depression alternating with hypnotic
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could be called mild form of bipolar - 1/3 go on to develop bipolar
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all of the above
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[blank_start]Etiology[blank_end] of Bipolar Disorder:
-interaction of social, biological, psychological variables
Stress & mood disorders:
-life stress, loss of some kind
-most cases of MDD are preceded by stressful [blank_start]life event[blank_end]
-psychodynamic perspectives (anger turned upwards)
Coping Styles & Social Support:
-may act as buffers
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Etiology
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beginning
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start
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variables
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life event
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people in their lives
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coping strategies
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in terms of the humanistic perspective, depression may result from the inability to find meaning & purpose in one's life
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Aaron Beck:
-negative [blank_start]schemas[blank_end] & expectations ("Im not good enough")
-cognitive distortions
-distorted [blank_start]thinking[blank_end]
-negative view of: oneself, environment, future
-learned helplessness/ [blank_start]hope[blank_end]lessness
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Biological Models:
(A) [blank_start]Genetic[blank_end] Evidence:
-depression & bipolar run in [blank_start]families[blank_end]
-family studies: the closer genetic relationship
*Genetic contribution is stronger for bipolar vs. depressive
(B) Biochemical Factors & Brain Abnormalities:
-cause or effect?
Catechloamine Ho: non-functioning NE or DA
-depression- receptors too few or insensitive
support= anti-depressants boost NE work
Prefrontal cortex: lower metabolic activity--> lower motivation
*limbic system abnormalities:
-[blank_start]hippocampus[blank_end]: lower metabolic activity: higher levels of cortisol
-[blank_start]amygdala[blank_end]: enlarged
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families
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blood
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DNA
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Genetic
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Biological
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Cognitive
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hippocampus
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Amygdala
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Pre-frontal Cortex
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amygdala
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Hippocampus
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frontal lobe
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Psychological Treatment:
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Interpersonal Psychotherapy
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Behavioural approaches
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Cognitive-Based Treatment (CBT)
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Antidepressant Pharmacotherapy
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Mood stabilizers
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ECT (Electroconvulsive therapy
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Transcranial Magnetic Stimulation (TMS) For depression
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all of the above
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90% of those who complete suicide are mentally ill at the time of their death
over 70% are clinically depressed
as many as 75% of adolescents suicides had a mood disorder