Chapter 5 (Depressive Disorders)
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Questions and Answers

What is the minimum duration for an episode to be classified as Major Depression?

  • 4 weeks
  • 3 weeks
  • 1 week
  • 2 weeks (correct)

Which of the following best describes Major Depression - Recurrent?

  • Several episodes, each lasting 2 weeks or more (correct)
  • Multiple episodes lasting less than 2 weeks
  • Continuous depression for more than 2 weeks without recovery
  • A single episode lasting over 2 weeks

What does the DSM-5 use to clarify variations in Major Depressive Disorder?

  • Treatment methods and duration
  • Symptoms inventory and duration
  • Specifiers for severity and episodes (correct)
  • Categories of age and gender

What does the term 'specifiers' refer to in the context of Major Depressive Disorder?

<p>Extensions to clarify variations in diagnosis (C)</p> Signup and view all the answers

Which severity level is NOT typically used to classify Major Depression?

<p>Extreme (A)</p> Signup and view all the answers

What is one of the symptoms that must be present for a diagnosis of persistent depressive disorder?

<p>Poor appetite or overeating (A)</p> Signup and view all the answers

How long must symptoms be present for a diagnosis of persistent depressive disorder in adults?

<p>2 years (A)</p> Signup and view all the answers

Which of the following is NOT a criterion for persistent depressive disorder?

<p>Symptoms were present for less than 2 months at a time (A)</p> Signup and view all the answers

What type of episode must never have occurred for a diagnosis of persistent depressive disorder?

<p>Manic episode (A)</p> Signup and view all the answers

Which of these symptoms indicates significant distress or impairment in functioning necessary for diagnosis of persistent depressive disorder?

<p>Low energy or fatigue (B)</p> Signup and view all the answers

What has changed in the classification of mood disorders from DSM-IV to DSM-5?

<p>There are now separate categories for depressive and bipolar disorders. (B)</p> Signup and view all the answers

Which of the following topics is NOT a learning objective related to depressive disorders?

<p>Identifying the historical context of mood disorders. (D)</p> Signup and view all the answers

Which of the following features is associated with depressive disorders?

<p>Persistent feelings of sadness. (A), Total lack of motivation in various activities. (B)</p> Signup and view all the answers

What is one of the learning objectives regarding the causes of major depressive disorders?

<p>Understanding a combination of biological, psychological, and social theories. (B)</p> Signup and view all the answers

Which of the following statements is true regarding the DSM-5 and its categorization of disorders?

<p>Mood disorders terminology is completely eliminated. (A)</p> Signup and view all the answers

What is a feature of melancholic depression?

<p>Inability to experience pleasure (B)</p> Signup and view all the answers

How are depressive disorders currently understood in psychological research?

<p>They are influenced by a mixture of factors including biological, psychological, and social. (B)</p> Signup and view all the answers

Which disorder involves depressed mood for at least 2 years?

<p>Persistent Depressive Disorder (Dysthymia) (A)</p> Signup and view all the answers

Which approach is effective in preventing the onset of depression?

<p>Regular physical exercise. (C)</p> Signup and view all the answers

Which subtype of depressive disorder is characterized by physical immobility?

<p>Catatonia (D)</p> Signup and view all the answers

Which aspect is NOT typically associated with the prevalence of depression in various groups?

<p>Individual's favorite hobbies and interests. (C)</p> Signup and view all the answers

Which of the following is NOT a subtype of depressive disorders?

<p>Social Anxiety Disorder (C)</p> Signup and view all the answers

What characterizes the peripartum onset subtype of depression?

<p>Occurs during pregnancy or shortly after (D)</p> Signup and view all the answers

Which depressive disorder can manifest due to another medical condition?

<p>Depressive Disorder Due to Another Medical Condition (C)</p> Signup and view all the answers

In what circumstance can children and adolescents display a different form of depression compared to adults?

<p>Their mood may be irritable rather than depressed. (C)</p> Signup and view all the answers

Which depressive disorder is characterized by significant mood disturbances before the menstrual period?

<p>Premenstrual Dysphoric Disorder (D)</p> Signup and view all the answers

What percentage of antidepressant trials appeared positive according to published literature?

<p>94% (D)</p> Signup and view all the answers

Which psychotherapy focuses primarily on current relationships?

<p>Interpersonal Psychotherapy (IPT) (C)</p> Signup and view all the answers

What is a key component of Cognitive Therapy as mentioned in the content?

<p>Identifying automatic thoughts (D)</p> Signup and view all the answers

What does Cognitive Restructuring attempt to address?

<p>Challenging and replacing negative thoughts (B)</p> Signup and view all the answers

In Judith Beck's description, how is 'talk therapy' characterized?

<p>Directive and didactic (D)</p> Signup and view all the answers

What are considered basic questions in the Cognitive Restructuring process?

<p>What’s the evidence? What are alternative explanations? (A)</p> Signup and view all the answers

Which of the following therapies includes components of behavioral activation?

<p>Behavioural Therapy (B)</p> Signup and view all the answers

What is a common misconception about Cognitive Therapy?

<p>It does not involve any behavioral components. (A)</p> Signup and view all the answers

What is the minimum duration required for diagnosing Persistent Depressive Disorder (Dysthymia)?

<p>2 years (D)</p> Signup and view all the answers

Which demographic group is more likely to experience depression based on prevalence rates?

<p>Women (D)</p> Signup and view all the answers

What is a common risk factor associated with developing depression in young people?

<p>High levels of anxiety (B)</p> Signup and view all the answers

At what approximate age does depression typically onset based on the provided data?

<p>30 years (A)</p> Signup and view all the answers

What is the prevalence of depression in women over a one-year period in Australia?

<p>5.1 percent (D)</p> Signup and view all the answers

Which factor is NOT identified as a risk factor for developing depression?

<p>Having a degree in higher education (B)</p> Signup and view all the answers

What percentage of men are estimated to experience depression over a one-year period in Australia?

<p>3.1 percent (B)</p> Signup and view all the answers

Which activity is associated with a higher risk of developing depression?

<p>Substance abuse (C)</p> Signup and view all the answers

Flashcards

Depressive Disorders

Mental health conditions characterized by prolonged sadness, loss of interest, and other symptoms.

DSM-5 Changes

The DSM-5 separated "Mood Disorders" into "Depressive Disorders" and "Bipolar and Related Disorders" categories.

Mania

A mood state characterized by abnormally elevated or irritable mood, increased energy, and other symptoms.

Depression

A mood state characterized by feelings of sadness, loss of interest, or other symptoms that last for a prolonged period.

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Diagnostic Criteria

Specific set of symptoms that must be present to diagnose a mood disorder.

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Prevalence of Depression

The frequency of depression in different groups, including factors like age and gender.

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Causes of Depression

Biological, psychological, and social factors that may contribute to the development of major depressive disorders.

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Treatments for Depression

Methods used to manage and improve symptoms of depressive disorders.

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Major Depression

A mood disorder characterized by at least two weeks of depressed mood or loss of interest in activities, along with other symptoms like fatigue, sleep changes, and feelings of worthlessness.

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Major Depressive Disorder (MDD)

A mental health disorder characterized by persistent sadness, loss of interest, and other symptoms, causing significant distress and impairment in daily life. It includes various specifiers based on severity, episode frequency and recovery.

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Single Episode Depression

A depressive episode that occurs only once in a person's lifetime, lasting for at least two weeks.

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Recurrent Depression

Depressive episodes that occur more than once, each lasting at least two weeks, separated by periods of normal mood.

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DSM-5 Specifiers

Additional descriptions used in conjunction with a diagnostic label in the DSM-5 to clarify characteristics of the disorder, such as severity, episode frequency, and recovery levels.

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Anhedonia

Inability to experience pleasure or find enjoyment in activities that were previously pleasurable.

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Psychotic Features

Presence of delusions or hallucinations, which are false beliefs or sensory experiences not based in reality, respectively.

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Catatonia

Extreme physical immobility or excessive peculiar physical movements, such as repetitive gestures or grimacing.

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Peripartum Onset

Depression occurring during pregnancy or within 4 weeks after childbirth.

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Seasonal Pattern

Depressive episodes recurring during specific seasons, most commonly fall and winter.

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Dysthymia

A chronic, less severe form of depression, but lasting for at least 2 years.

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Disruptive Mood Dysregulation Disorder

A childhood disorder characterized by severe, recurrent temper outbursts and persistent irritable mood.

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Premenstrual Dysphoric Disorder

A severe form of premenstrual syndrome (PMS) with emotional and physical symptoms.

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Persistent Depressive Disorder

A chronic mood disorder characterized by persistent low mood and at least two other symptoms (e.g., poor appetite, insomnia, low energy) for most days for at least two years.

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Criteria A and B

These criteria refer to the presence of low mood and at least two other symptoms of depression for a specified period.

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2-year period

For adults, the symptoms of Persistent Depressive Disorder must be present for at least two years, with no more than two months without symptoms during that time.

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No Manic Episodes

Individuals with Persistent Depressive Disorder have never experienced manic or hypomanic episodes, which are characteristic of bipolar disorders.

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Risk factors for Depression

Factors that increase the likelihood of developing depression.

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What is the median age of onset for depression?

The middle age at which most individuals experience their first episode of depression.

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Depression in Young People

Depression in young people can be related to higher levels of anxiety, substance abuse and other risk factors.

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Gender Differences in Depression

Women are diagnosed with depression twice as often as men.

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Depressive Disorders: General Description

Depressive disorders are a group of mental illnesses characterized by prolonged periods of sadness, loss of interest or pleasure, and other symptoms causing significant distress and impairment.

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Aetiology of Depressive Disorders

The study of the causes of depressive disorders, encompassing biological, psychological, and social factors.

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Selective Publication Bias

The tendency to publish research findings that show positive results of a treatment, while studies with negative or inconclusive results are less likely to be published.

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FDA vs. Published Efficacy

The discrepancy between the effectiveness of antidepressants reported in published studies compared to the findings from the Food and Drug Administration (FDA) reviews, which often show a lower rate of positive outcomes.

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Interpersonal Psychotherapy (IPT)

A short-term therapy focused on improving relationships and interpersonal skills to address depression. Key aspects include understanding and changing patterns of communication and behavior in relationships.

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Behavioral Activation

A therapy technique used in behavioral therapy for depression, focusing on increasing engagement in activities that provide pleasure, mastery, and purpose, to improve mood and reduce depressive symptoms.

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Cognitive Therapy

Therapy that aims to identify and challenge negative thought patterns, replacing them with more realistic and positive ones to improve emotional well-being.

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Automatic Thoughts

Thoughts that automatically appear in our minds, often triggered by events or situations, and can contribute to negative emotions and behaviors.

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Cognitive Restructuring

A process used in cognitive therapy to identify and challenge negative or distorted thoughts and beliefs, helping to shift those patterns toward more accurate and positive ones.

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Talk Therapy

A general term for a range of therapies that involve verbal interaction between a therapist and client to address mental health issues.

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Study Notes

  • Material reproduced and communicated by the University of South Australia is subject to copyright under the Copyright Act 1968
  • Further reproduction or communication is also subject to copyright

Chapter 5: Depressive Disorders

  • This chapter discusses depressive disorders
  • Learning objectives include describing diagnostic criteria, understanding prevalence, exploring biological, psychological and social theories behind causes, and understanding effective treatments.
  • Treatments also include approaches to reduce relapse and prevent onset.

DSM-5 Changes

  • DSM-IV "Mood Disorders" included both depressive and bipolar disorders
  • DSM-5 (and DSM-5-TR) separate "Depressive Disorders" and "Bipolar and Related Disorders"
  • DSM now no longer has a "Mood Disorders" category.

DSM-5 Changes (Depressive Disorders)

  • Bereavement is no longer excluded from a major depression diagnosis.
  • Prolonged Grief Disorder added to Trauma- and Stressor-Related Disorders
  • Dysthymic disorder renamed "persistent depressive disorder"

Terminology

  • Unipolar Disorder is either depression or mania.
  • Bipolar Disorder usually alternates between mania and depression.

DSM-5 Depressive Disorders

  • Includes Disruptive Mood Dysregulation Disorder, Major Depressive Disorder, Persistent Depressive Disorder (Dysthymia), Premenstrual Dysphoric Disorder, Substance/Medication-Induced Depressive Disorder, Depressive Disorder Due to Another Medical Condition, Other Specified Depressive Disorder, and Unspecified Depressive Disorder.

Historical Approaches

  • In Ancient Greece, "melancholia" was fear and depression
  • Emil Kraepelin (1896) identified manic depressive insanity as a category of mental illness
  • Karl Leonhard (1957) distinguished unipolar depression and bipolar disorder

Depressive Disorders

  • General description
  • Epidemiology
  • Etiology
  • Treatment

DSM Defined [Mood] Episodes

  • Primary depressive (and bipolar) disorders are based on the presence or absence of various types of episodes (Major Depressive, Manic, Hypomanic)

DSM-5 Diagnostic Criteria for Major Depressive Episode

  • Five (or more) symptoms in a 2-week period, representing a change from previous functioning; at least one symptom is either depressed mood or loss of interest/pleasure
  • Symptoms include depressed mood, diminished interest, significant weight change, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, feelings of worthlessness, diminished concentration, recurrent thoughts of death, suicidal ideation or attempts
  • Symptoms must be clinically significant and not attributable to substances or other medical conditions.

DSM-5 Diagnostic Criteria for Major Depressive Disorder

  • One or more major depressive episodes
  • Episodes not better explained by another mental disorder
  • No prior history of manic or hypomanic episodes

Depressive Disorders: Major Depression – Recurrent

  • DSM-5 includes "specifiers" in clinical diagnosis
  • These clarify variability such as: severity, number of episodes, and degree of recovery

Subtypes of Depressive Disorders

  • Anxious distress
  • Melancholic features
  • Psychotic features
  • Catatonia
  • Peripartum onset
  • Seasonal pattern

DSM-5 Diagnostic Criteria for Persistent Depressive Disorder

  • Depressed mood for most of the day, for at least two years (one year for children and adolescents)
  • Two or more symptoms: poor appetite/overeating, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration, feelings of hopelessness

Epidemiology of Depressive Disorders

  • Prevalence of depression varies by demographics, gender, and time frames (1 year).
  • Women are frequently twice as likely to experience depression than men.
  • Risk factors include anxiety, substance abuse, family conflict, trauma, residing in rural areas, Aboriginal/Torres Strait Islander descent, and parental psychological issues.

Additional Problems Associated with Depressive Disorders

  • Increased risk of suicide
  • Impaired social and work functioning
  • Co-morbid anxiety
  • Increased physical health problems

Symptom Variation and Depressive Disorders

  • Symptoms vary across cultures and age groups.
  • Complaints can vary between cultures (Latino/Asian examples)
  • Symptoms vary across different age groups (differences between children/older adults)

More on Gender Differences in Depressive Disorders

  • Women are more likely to be diagnosed with MDD.
  • Differences emerge in adolescence.
  • Possible causes/factors: hormonal differences , differences in experiences of chronic stress, body image issues, interpersonal losses, and gender differences in coping mechanisms, or measurement issues.

Aetiology of Depressive Disorders

  • Biological factors: genetic component, neurotransmitter activity, HPA axis, structural/functional abnormalities in brain regions (PFC, hippocampus, ACC, amygdala), inflammation.
  • Environmental factors: stressful life events such as financial issues, abuse, etc, family environment, upbringing etc.
  • Social factors: interpersonal difficulties, high expressed emotion, lack of social support.
  • Psychological factors: cognitive theories, behavioral theories, psychoanalytic theories.

Treatment of Depressive Disorders

  • Pharmacological (medications)
  • Physical (repetitive transcranial magnetic stimulation, vagus nerve stimulation, bright light therapy, electroconvulsive therapy)

Medications for Treating Depressive Disorders

  • Include MAO inhibitors, tricyclic antidepressants, SSRIs, mood stabilizers, anticonvulsants, antipsychotics, etc.

Psychological Treatment of Depressive Disorders

  • Interpersonal Psychotherapy
  • Behavioral therapy
  • Cognitive therapy (CBT)

Cognitive Therapy

  • Includes techniques like cognitive restructuring, which aims to identify, challenge, and replace negative thoughts
  • Basic questions used in cognitive restructuring include: What is the evidence?, What are alternative explanations?, What are the realistic implications?

Self-help Approaches

  • Provide examples of self-help programs like "Feeling Good" by David D. Burns.

Relapse Prevention

  • Include medication, CBT/IPT treatment plans, and wellness strategies
  • Interventions addressing factors like triggers, re-emerging symptoms, and preventive cognitive therapies are all important strategies.

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