Podcast
Questions and Answers
Which of the following is classified under depressive disorders in the DSM-5?
Which of the following is classified under depressive disorders in the DSM-5?
What is the lifetime prevalence of major depressive disorder?
What is the lifetime prevalence of major depressive disorder?
Which population has relatively high rates of depression compared to others mentioned?
Which population has relatively high rates of depression compared to others mentioned?
What distinguishes unipolar mood disorders from bipolar mood disorders?
What distinguishes unipolar mood disorders from bipolar mood disorders?
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How does the prevalence of bipolar I disorder compare to that of major depressive disorder?
How does the prevalence of bipolar I disorder compare to that of major depressive disorder?
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Which symptom is NOT required for the diagnosis of Persistent Depressive Disorder (Dysthymia)?
Which symptom is NOT required for the diagnosis of Persistent Depressive Disorder (Dysthymia)?
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What is the lifetime prevalence rate of Persistent Depressive Disorder (Dysthymia)?
What is the lifetime prevalence rate of Persistent Depressive Disorder (Dysthymia)?
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Which of the following statements about genetic factors in unipolar depression is accurate?
Which of the following statements about genetic factors in unipolar depression is accurate?
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According to cognitive theory, what do depressed individuals tend to do?
According to cognitive theory, what do depressed individuals tend to do?
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What describes the average duration of untreated Major Depressive Episodes?
What describes the average duration of untreated Major Depressive Episodes?
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What is a requirement for diagnosing Major Depressive Disorder?
What is a requirement for diagnosing Major Depressive Disorder?
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Which factor does NOT contribute to the diagnosis of Dysthymic Disorder?
Which factor does NOT contribute to the diagnosis of Dysthymic Disorder?
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What is the common age of onset for Major Depressive Disorder?
What is the common age of onset for Major Depressive Disorder?
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Which demographic shows higher rates of Persistent Depressive Disorder (Dysthymia)?
Which demographic shows higher rates of Persistent Depressive Disorder (Dysthymia)?
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What role does sleep play in biological factors of unipolar depression?
What role does sleep play in biological factors of unipolar depression?
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According to psychodynamic theories, depression often results from what?
According to psychodynamic theories, depression often results from what?
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What common cognitive distortion is associated with depression?
What common cognitive distortion is associated with depression?
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How does the sex ratio for Major Depressive Disorder compare for men and women?
How does the sex ratio for Major Depressive Disorder compare for men and women?
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What percentage of individuals experience a recurrence of Major Depressive Episodes?
What percentage of individuals experience a recurrence of Major Depressive Episodes?
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Which symptom is NOT associated with a manic episode?
Which symptom is NOT associated with a manic episode?
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What is the minimum duration required for diagnosing a hypomanic episode?
What is the minimum duration required for diagnosing a hypomanic episode?
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Which factor is NOT considered a biological causal factor in the development of bipolar disorder?
Which factor is NOT considered a biological causal factor in the development of bipolar disorder?
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In which disorder do hypomanic and depressive symptoms not reach the severity of manic or major depressive episodes?
In which disorder do hypomanic and depressive symptoms not reach the severity of manic or major depressive episodes?
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What percentage of individuals with mood disorders typically receive adequate treatment?
What percentage of individuals with mood disorders typically receive adequate treatment?
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Which psychological response style is associated with longer and more severe episodes of depression?
Which psychological response style is associated with longer and more severe episodes of depression?
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Which of the following is a demographic characteristic of bipolar disorder prevalence?
Which of the following is a demographic characteristic of bipolar disorder prevalence?
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Which theory of depression emphasizes the role of personality variables and social support?
Which theory of depression emphasizes the role of personality variables and social support?
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What is a common treatment method for mood disorders?
What is a common treatment method for mood disorders?
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Which of the following episodes is associated with significant impairment in functioning?
Which of the following episodes is associated with significant impairment in functioning?
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What is the average age of onset for bipolar disorders?
What is the average age of onset for bipolar disorders?
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Which of the following symptoms does NOT indicate a hypomanic episode?
Which of the following symptoms does NOT indicate a hypomanic episode?
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What is the heritability rate for developing bipolar disorder?
What is the heritability rate for developing bipolar disorder?
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Which is a common misconception regarding the treatment of mood disorders?
Which is a common misconception regarding the treatment of mood disorders?
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Study Notes
Mood Disorders
- Depression: Feelings of sadness, hopelessness, lack of energy, and loss of interest in life
- Mania: Excessive and unrealistic feelings of excitement, euphoria, and overactivity
- Unipolar: Only depressive episodes
- Bipolar: Both depressive and manic episodes
Mood Disorders in DSM-5
- Mood disorders are in two different categories in DSM-5
- Depressive Disorders
- Bipolar and Related Disorders
Epidemiology of Mood Disorders
- Nearly 17% lifetime prevalence of major depressive disorder
- 12-month prevalence rates are nearly 7%
- About twice as common in women than men
- Lifetime prevalence for bipolar I disorder is near 1%
- Overall bipolar disorders: 2-3%
- Native Americans have relatively high rates of depression
- Black/African-Americans have relatively low rates
- U.S. rates of unipolar depression are inversely related to socioeconomic status
Mood Episodes
- Not meant to be diagnosed as separate entities
- Serve as building blocks for the specific disorder diagnoses
- Major Depressive Episode
- 2-week period, symptoms including depressed mood or loss of interest or pleasure
- Manic Episode
- 1-week period, distinct period of elevated, expansive, or irritable mood
- Hypomanic Episode
- 4-day period, distinct period of elevated, expansive, or irritable mood, not severe enough to cause marked impairment in functioning
Major Depressive Episode
- 5 or more of the following symptoms must be present for at least 2 weeks:
- Depressed mood most of the day
- Markedly diminished interest or pleasure in nearly all activities (Anhedonia)
- Significant weight loss, or decreased appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Diminished concentration or indecisiveness
- Recurrent thoughts of death, suicide ideation, or plan
Major Depressive Disorder
- Presence of a single Major Depressive Episode (MDE)
- Absence of a Manic or Hypomanic episode
- Not due to a substance
- Not due to a different disorder
- Causes clinically significant distress or impairment
Prevalence of MDD
- Lifetime prevalence: 17%
- 12-month prevalence rates are nearly 7%
- Sex ratio 2:1
- ~20% women dx
- ~13% men dx
- Age of onset: mid-20s
- Earlier age of onset predicts worse prognosis
Persistent Depressive Disorder (Dysthymia)
- Depressed mood for most of the day, more days than not for at least 2 years (1 year for children)
- Presence of 2 or more of the following:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration
- Feelings of hopelessness
- During the 2-year period, no more than 2 months of normal functioning
- Can meet criteria for MDD (“double depression”)
- No manic or hypomanic episodes
- Not due to another disorder or a substance
- Clinically significant distress or impairment
Prevalence & Course
- Lifetime: ~3%
- Women diagnosed 2-3 times more often than men
- Early and insidious onset
- Early onset → greater chronicity, poor response to treatment
- Chronic course
- Avg. 5 yrs, ranges to 20 yrs duration
Biological Causal Factors in Unipolar Depression
- Genetic Influences
- Twin studies: MZ twin is twice as likely to develop unipolar depression as a DZ twin
- Heritability: 31% to 42% due to genetics
- Neurochemical Factors
- Reduced dopaminergic activity
- Dopamine: pleasure experience
Biological Causal Factors (Continued)
- Sleep and other biological rhythms
- Depressed patients may have:
- Early morning awakening
- Periodic awakening during the night
- Difficulty falling asleep
- Depressed patients may have:
- Depressed patients enter the first period of REM after only 60 minutes (15-20 mins sooner than nondepressed people) and show greater amounts of REM sleep
Psychological Causal Factors
- Psychodynamic Theories
- Response to real and symbolic loss
- Anger turned inward
- Behavioral Theories
- Depression occurs in the absence of positive reinforcement
- Depressed people receive less positive reinforcement from family and friends and experience more negative events than nondepressed people
Psychological Causal Factors (Continued)
- Cognitive Theory
- Depressed people tend to be primed for and remember negative events more easily and frequently
- Beck’s Model of Depression
- Learned Helplessness
- Attributing lack of control over stress leads to anxiety and depression
- Abramson's Reformulated Helplessness Theory: Depressive attributional style
- Internal: attribute negative events to personal failing (my fault)
- Stable: even after a negative event passes, assumption of future failures (always will happen)
- Global: generalizing of shortcomings to a wide range of circumstances (regardless of situation)
Psychological Causal Factors (Continued)
- Ruminative Response Styles:
- Rumination: a pattern of repetitive and passive mental activity (typically related to negative feelings about an event or situation)
- Women are more likely to ruminate than men
- Interpersonal Causal Factors
- Depressed individuals often:
- Have sparse social networks
- Perceive social network as providing little support
- Depression can elicit sympathy and care, but it can also elicit hostility and rejection from others
- Depressed individuals often:
Bipolar Disorders
- Distinguished from unipolar disorders by the presence of manic or hypomanic symptoms
- Cyclothymic Disorder
- Bipolar I Disorder
- Bipolar II Disorder
Bipolar Disorders (Continued)
- Building blocks of Bipolar Disorders:
- Major Depressive Episodes
- Manic Episodes
- Hypomanic Episodes
Manic Episode
- Distinct period of elevated, expansive, or irritable mood, lasting at least 1 week
- 3 or more of the following symptoms present:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual / pressured speech
- Flight of ideas / racing thoughts
- Distractibility
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in pleasurable activities that have high potential for negative consequences
Hypomanic Episode
- Distinct period of elevated, expansive, or irritable mood, lasting at least 4 days
- 3 or more manic symptoms are present
- Episode is associated with definite change in person’s characteristic functioning
- Disturbance in mood and change in functioning is observable by others
- Not severe enough to cause marked impairment in functioning
Mood Episodes (Continued)
- Manic Episode:
- Duration: 1 week
- At least 3/7 symptoms
- Significant impairment in functioning
- Hypomanic Episode:
- Duration: 4 days
- At least 3/7 symptoms
- NO significant impairment in functioning
Bipolar Disorders (Continued)
- Bipolar I
- 1+ Manic Episodes (required)
- 1+ Major Depressive Episode (not required but typically accompany manic episode)
- Bipolar II
- 1+ Major Depressive Episodes
- 1+ Hypomanic Episodes
Cyclothymic Disorder
- Hypomanic & depressive symptoms that do not reach severity of manic or major depressive episodes
- Tends to be predominantly one or the other for long periods of time with few periods of neutral mood states
- Duration at least 2 years
- Interferes with functioning
- ~ 30% chance of developing Bipolar I or II
Prevalence
- Lifetime: ~4.4%
- Occurs equally in men and women
- Men typically have more intense manic episodes
- Women experience rapid cycling more often
- High suicide rate (10-30 times more likely than the general population risk)
Course of BDs
- Average age of onset: 18-22 years
- Depressive episodes typically last 3-4 mos in BD
- Some people experience rapid cycling (4+ episodes per year)
- Very small chance of BD II developing into BD II
- Course is typically long term and chronic even with treatment
Biological Causal Factors
- Heritability
- 80-90% variance in the vulnerability to develop Bipolar Disorder due to genes
- Neurochemical Factors
- Monoamine Hypothesis: excess norepinephrine
- Dopamine: increased dopaminergic activity results in manic behaviors
Psychological Causal Factors
- Stressful life events
- Personality variables (such as neuroticism and high levels of achievement striving)
- Low social support
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Description
Explore the various types of mood disorders including depression and mania, and learn how they are categorized in the DSM-5. This quiz also delves into the epidemiology of these disorders and their prevalence across different populations. Test your knowledge on the essential aspects of mood disorders.
