45 Questions
According to the diagnostic criteria for Major Depressive Disorder, how many symptoms must be present during the same 2-week period?
Five or more symptoms
Which two symptoms are necessary to meet the diagnostic criteria for Major Depressive Disorder?
Depressed mood and diminished interest and pleasure
According to the DSM-5, what does the exclusion criterion for diagnosing MDD refer to?
The exclusion of individuals whose symptoms are due to the physiological effects of a substance or another medical condition
What is the purpose of criterion C in the DSM-V criteria for Major Depressive Disorder?
To rule out the influence of substances or other medical conditions on the episode.
According to the DSM-5, for a diagnosis of MDD, the symptoms must cause clinically significant distress or impairment in which areas of an individual's life?
Social, occupational, or other important areas of functioning
What is not one of the criteria for diagnosing Major Depressive Disorder?
Loss of guilt
Which symptom is not part of the diagnostic criteria for Major Depressive Disorder?
Improved ability to concentrate
Which of the following is NOT a symptom of Major Depressive Disorder?
Increased energy
Which of the following statements accurately describes the bereavement exclusion criterion for the diagnosis of major depression?
It disqualifies individuals from being diagnosed with major depression if they have experienced a recent bereavement.
What significant change occurred in the introduction of the DSM-5 regarding the exclusion criterion for Bereavement?
The exclusion criterion for Bereavement was completely removed.
Which two major psychiatric diagnostic systems did not have the grief exclusion criterion present?
A. The DSM-III and the DSM-IV
Under what conditions can someone who is bereaved be diagnosed with Major Depressive Disorder (MDD)?
B. If their symptoms persist for over 2 months and are characterized by functional impairment, worthlessness, or suicidal ideation
According to the medication responsiveness argument, why should people who have not been diagnosed with MDD on the basis of the bereavement exclusion be considered to have a depressive disorder?
They respond to medication
What is the strength of the medication responsiveness argument?
It is a weak argument that lacks evidence
What evidence is there to support the claim that bereaved individuals treated with medication actually benefit?
There is little evidence to support the claim
Which of the following statements accurately describes the change in the DSM-5 regarding the bereavement exclusion criterion?
The bereavement exclusion criterion now includes a note that allows for the consideration of a major depressive episode in addition to a normal response to a significant loss.
What factors should be considered when determining if the presence of a major depressive episode is appropriate in addition to a normal response to a significant loss?
The individual's history and cultural norms for the expression of distress
Which of the following best describes the genetic complexity of Major Depressive Disorder?
MDD is influenced by multiple genes.
What is the heritability estimate for Major Depressive Disorder based on twin studies?
40 - 50%
What is the relative risk ratio for Major Depressive Disorder in adopted children compared to the population base rate?
2 to 3 times the population base rate
Which drug was one of the first antidepressants to be developed in the 1950s?
Iproniazid
What is the main function of monoamine oxidase inhibitors (MAOIs) in the body?
Inhibit the enzyme that breaks down norepinephrine
In an early study, how many female patients showed a favorable response to iproniazid treatment after 5 months?
70%
Which neurotransmitter does Imipramine block the recycling of?
Norepinephrine
What was the original purpose of developing Imipramine?
To replicate the success of chlorpromazine
What was the result of using Imipramine as a neuroleptic?
It was found to be ineffective
Which neurotransmitter does reserpine deplete in the brain?
Serotonin
What is the hypothesized cause of reserpine's depressive-like effects?
Serotonin depletion
What are the effects of reserpine on behavior?
Lethargy
What is the association between the amount of neurotransmitters and levels of depression according to the hypothesis?
Lower levels of neurotransmitters lead to higher levels of depression.
What impact is expected on depressive symptoms when manipulating the level of the transmitters of interest?
Manipulating the levels of transmitters will have a subsequent impact on depressive symptoms.
What evidence has been taken for support for biological models of depression?
Low monoamine levels have been found in depressed individuals.
What is a possible explanation for the inconsistent findings regarding monoamine levels in depressed individuals?
There are multiple pathways to depression.
What is the main argument against low monoamine levels being a reliable characteristic of depression?
Inconsistent findings of low monoamine levels across depressed individuals
Which term refers to the intended action or goal of a specific intervention or treatment?
Procedure
What is the process that is being evoked when reducing the uptake of serotonin in the body?
Depression
Which type of evidence has supported biological models of depression?
Responses to antidepressant medication
What is a conflicting finding in relation to antidepressant medication?
Tianeptine is an effective antidepressant even though it reduces serotonin in the brain
Which neurotransmitter is more likely to cause a return of depressive symptoms when depleted in individuals in remission from depression via SSRIs?
Serotonin
What is the impact of monoamine depletion on depressive symptoms in healthy subjects without a history of depression?
It does not typically induce depressive symptoms
What do findings from monoamine depletion studies suggest about the role of monoamine neurotransmitters in depression?
There is not great evidence that monoamine neurotransmitters play a role in depression
Which type of treatment is commonly used for depression?
Antidepressants
What did Kirsch et al. find in their meta-analysis of antidepressant studies?
Antidepressants have a small to medium effect on depression
According to Kirsch et al., which group of participants showed the greatest evidence of antidepressant efficacy?
Participants with high levels of depression
What was the overall finding of the meta-analysis regarding the effectiveness of antidepressants compared to placebo?
Antidepressants were more effective than placebo
Study Notes
Major Depressive Disorder (MDD)
- To meet the diagnostic criteria for MDD, at least five symptoms must be present during the same 2-week period.
- Two necessary symptoms to meet the diagnostic criteria for MDD are depressed mood and loss of interest or pleasure in activities.
Diagnostic Criteria for MDD
- The exclusion criterion for diagnosing MDD refers to bereavement.
- Criterion C in the DSM-V criteria for MDD ensures that the symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of an individual's life.
Bereavement Exclusion Criterion
- In the DSM-5, the bereavement exclusion criterion was removed, allowing individuals who are bereaved to be diagnosed with MDD.
- The bereavement exclusion criterion was not present in the ICD-10 and the Research Diagnostic Criteria (RDC).
- A person who is bereaved can be diagnosed with MDD if they experience symptoms that persist beyond two months or if their symptoms are severe.
Genetic Complexity of MDD
- The heritability estimate for MDD based on twin studies is around 37%.
- The relative risk ratio for MDD in adopted children compared to the population base rate is 2.5.
History of Antidepressants
- Iproniazid was one of the first antidepressants to be developed in the 1950s.
- Monoamine oxidase inhibitors (MAOIs) function by blocking the breakdown of neurotransmitters in the body.
- Imipramine blocks the recycling of norepinephrine, and it was originally developed as a neuroleptic.
- Reserpine depletes serotonin, dopamine, and norepinephrine in the brain, leading to depressive-like effects.
Biological Models of Depression
- The Monoamine Hypothesis states that a decrease in neurotransmitters (serotonin, dopamine, and norepinephrine) contributes to depression.
- Manipulating the level of neurotransmitters of interest is expected to impact depressive symptoms.
- Monoamine depletion studies suggest that monoamine neurotransmitters play a role in depression.
Treatment and Interventions
- The term "mechanism" refers to the intended action or goal of a specific intervention or treatment.
- Reducing the uptake of serotonin in the body is an example of a reuptake inhibition process.
- Biological models of depression are supported by evidence from monoamine depletion studies and antidepressant treatment.
- Antidepressant medication is commonly used to treat depression, but findings from monoamine depletion studies suggest that depleting serotonin, in particular, can cause a return of depressive symptoms in individuals in remission from depression.
Test your knowledge of the diagnostic criteria for Major Depressive Disorder with this quiz. Determine how many symptoms must be present during a 2-week period and identify the two necessary symptoms for the diagnosis. Choose the correct answers from the options provided.
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