Podcast
Questions and Answers
What is the minimum duration for an episode to be classified as Major Depression?
What is the minimum duration for an episode to be classified as Major Depression?
Which of the following best describes Major Depression - Recurrent?
Which of the following best describes Major Depression - Recurrent?
What does the DSM-5 use to clarify variations in Major Depressive Disorder?
What does the DSM-5 use to clarify variations in Major Depressive Disorder?
What does the term 'specifiers' refer to in the context of Major Depressive Disorder?
What does the term 'specifiers' refer to in the context of Major Depressive Disorder?
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Which severity level is NOT typically used to classify Major Depression?
Which severity level is NOT typically used to classify Major Depression?
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What is one of the symptoms that must be present for a diagnosis of persistent depressive disorder?
What is one of the symptoms that must be present for a diagnosis of persistent depressive disorder?
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How long must symptoms be present for a diagnosis of persistent depressive disorder in adults?
How long must symptoms be present for a diagnosis of persistent depressive disorder in adults?
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Which of the following is NOT a criterion for persistent depressive disorder?
Which of the following is NOT a criterion for persistent depressive disorder?
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What type of episode must never have occurred for a diagnosis of persistent depressive disorder?
What type of episode must never have occurred for a diagnosis of persistent depressive disorder?
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Which of these symptoms indicates significant distress or impairment in functioning necessary for diagnosis of persistent depressive disorder?
Which of these symptoms indicates significant distress or impairment in functioning necessary for diagnosis of persistent depressive disorder?
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What has changed in the classification of mood disorders from DSM-IV to DSM-5?
What has changed in the classification of mood disorders from DSM-IV to DSM-5?
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Which of the following topics is NOT a learning objective related to depressive disorders?
Which of the following topics is NOT a learning objective related to depressive disorders?
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Which of the following features is associated with depressive disorders?
Which of the following features is associated with depressive disorders?
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What is one of the learning objectives regarding the causes of major depressive disorders?
What is one of the learning objectives regarding the causes of major depressive disorders?
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Which of the following statements is true regarding the DSM-5 and its categorization of disorders?
Which of the following statements is true regarding the DSM-5 and its categorization of disorders?
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What is a feature of melancholic depression?
What is a feature of melancholic depression?
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How are depressive disorders currently understood in psychological research?
How are depressive disorders currently understood in psychological research?
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Which disorder involves depressed mood for at least 2 years?
Which disorder involves depressed mood for at least 2 years?
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Which approach is effective in preventing the onset of depression?
Which approach is effective in preventing the onset of depression?
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Which subtype of depressive disorder is characterized by physical immobility?
Which subtype of depressive disorder is characterized by physical immobility?
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Which aspect is NOT typically associated with the prevalence of depression in various groups?
Which aspect is NOT typically associated with the prevalence of depression in various groups?
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Which of the following is NOT a subtype of depressive disorders?
Which of the following is NOT a subtype of depressive disorders?
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What characterizes the peripartum onset subtype of depression?
What characterizes the peripartum onset subtype of depression?
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Which depressive disorder can manifest due to another medical condition?
Which depressive disorder can manifest due to another medical condition?
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In what circumstance can children and adolescents display a different form of depression compared to adults?
In what circumstance can children and adolescents display a different form of depression compared to adults?
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Which depressive disorder is characterized by significant mood disturbances before the menstrual period?
Which depressive disorder is characterized by significant mood disturbances before the menstrual period?
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What percentage of antidepressant trials appeared positive according to published literature?
What percentage of antidepressant trials appeared positive according to published literature?
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Which psychotherapy focuses primarily on current relationships?
Which psychotherapy focuses primarily on current relationships?
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What is a key component of Cognitive Therapy as mentioned in the content?
What is a key component of Cognitive Therapy as mentioned in the content?
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What does Cognitive Restructuring attempt to address?
What does Cognitive Restructuring attempt to address?
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In Judith Beck's description, how is 'talk therapy' characterized?
In Judith Beck's description, how is 'talk therapy' characterized?
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What are considered basic questions in the Cognitive Restructuring process?
What are considered basic questions in the Cognitive Restructuring process?
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Which of the following therapies includes components of behavioral activation?
Which of the following therapies includes components of behavioral activation?
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What is a common misconception about Cognitive Therapy?
What is a common misconception about Cognitive Therapy?
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What is the minimum duration required for diagnosing Persistent Depressive Disorder (Dysthymia)?
What is the minimum duration required for diagnosing Persistent Depressive Disorder (Dysthymia)?
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Which demographic group is more likely to experience depression based on prevalence rates?
Which demographic group is more likely to experience depression based on prevalence rates?
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What is a common risk factor associated with developing depression in young people?
What is a common risk factor associated with developing depression in young people?
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At what approximate age does depression typically onset based on the provided data?
At what approximate age does depression typically onset based on the provided data?
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What is the prevalence of depression in women over a one-year period in Australia?
What is the prevalence of depression in women over a one-year period in Australia?
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Which factor is NOT identified as a risk factor for developing depression?
Which factor is NOT identified as a risk factor for developing depression?
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What percentage of men are estimated to experience depression over a one-year period in Australia?
What percentage of men are estimated to experience depression over a one-year period in Australia?
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Which activity is associated with a higher risk of developing depression?
Which activity is associated with a higher risk of developing depression?
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Study Notes
Copyright Notice
- 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.
Any Questions?
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