EXAM 3 STUDY GUIDE Chapter 7 Mood Disorders and Suicide 1 What are the symptoms of a Major Depressive Episode lecture textbook At least 5 of the following symptoms 1 Depressed Mood 2 Anhedonia 3 Appetite or Weight Changes 4 Sleep problems 5 Psychomotor Changes 6 Loss of Energy 7 Feelings of Worthlessness or Inappropriate Guilt 8 Concentration Problems 9 Suicidality 2 What are the diagnostic features of Major Depression and its associated subtypes Dysthymic Disorder Persistent Depressive Disorder and double depression How are these disorders similar and different lecture textbook Major Depression Diagnostic Features A Presence of a major depressive episode B Not better accounted for by another disorder C No history of a manic mixed or hypomanic episode Associated Subtypes 1 Anxious Distress worrying brooding 2 Mixed some evidence of mania hypomania 3 Melancholic features prominent physiological symptoms and anhedonia 4 Psychotic features delusions hallucinations 5 Catatonic features lack of movement disturbed speech 6 Atypical features assortment of odd symptoms 7 Peripartum Onset within 4 weeks of delivery of child 8 Seasonal Patterns Seasonal Affective Disorder Dysthymic Disorder At least 2 of the following for at least 2 years Less severe but more chronic o Appetite problems o Sleep problems o Low Energy o Low self esteem o Poor concentration o Feelings of hopelessness Double Depression Dysthymia often co occurs with other mental disorders A double depression is the occurrence of episodes of major depression in addition to dysthymia Switching between periods of dysthymic moods and periods of hypomanic moods is indicative of cyclothymia which is a mild variant of bipolar disorder Comparing Contrasting 3 How do rates of unipolar depression vary as a function of age gender and culture What are the proposed explanations for these differences discussed in class and the textbook see sociocultural theories of depression lecture textbook Unipolar mood disorders Double depression major depression dysthymia 16 of Americans experience an episode of major depression some time in their life Age Gender Women are 2X as likely as men to experience mild and severe depression Potential explanations for differences o Higher rates of sexual abuse assault among women o Socio cultural strains o Differences in functioning of hypothalamic pituitary adrenal HPA axis Plays a major role in regulating stress responses Culture 4 What are the symptoms of mania What are the similarities and differences between mania and hypomania lecture textbook Mania Bipolar I People with mania have unrealistically positive and grandiose self esteem They experience racing thoughts and impulses Possible that grandiose thoughts are delusional and accompanied by grandiose hallucinations In order to be diagnosed must show an elevated expansive or irritable mood for at least one week as well as at least 3 of the following symptoms o Inflated self esteem or grandiosity o Decreased need for sleep feels restless after only 3hrs of sleep o More talkative than usual or pressure to keep talking o Flight of ideas or subjective experience that thoughts are racing o Distractibility o Excessive involvement in activities that have a high potential for painful consequences unrestrained buying sprees sexual indiscretions or foolish business investments o These symptoms must impair the individuals functioning Almost all of these people will eventually fall into a depressive episode mania w o depression is rare o Can be as severe as major depressive episodes or mild and infrequent Hypomania Bipolar II People experience severe episodes of depression that meet the criteria for major depression but their episodes of mania are milder hypomania Involves the same symptoms of mania THE MAJOR DIFFERENCE IS THAT IN HYPOMANIA THESE SYMPTOMS ARE NOT SEVERE ENOUGH TO INTERFERE WITH DAILY FUNCTIONING DO NOT INVOLVE HALLUCINATIONS OR DELUSIONS AND LAST AT LEAST 4 CONSECUTIVE DAYS Criteria Major Depressive Episodes Bipolar I Can occur but are NOT Bipolar II Are necessary for diagnosis Episodes meeting full criteria for mania Hypomanic Episodes CANNOT be present for diagnosis Are necessary for diagnosis necessary for diagnosis Are necessary for diagnosis Can occur between episodes of severe mania or major depression but are NOT necessary for diagnosis 5 What are the diagnostic features for Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder and Rapid Cycling Bipolar Disorder How are these disorders similar and different lecture textbook Bipolar I II see above Cyclothymic Disorder a less severe but more chronic form of bipolar disorder o Person alternates between periods of hypomanic symptoms and periods of depressive symptoms chronically over at least a 2 year period o The hypomanic depressive symptoms are of insufficient number severity or duration to meet full criteria for full diagnosis of either o During periods of hypomania a person can function quite well o During periods of depression symptoms severely interfere with person s daily functioning o 15 50 develop Bipolar I or Bipolar II disorder Rapid Cycling Bipolar Disorder Four or more episodes that meet criteria for manic hypomanic or major depressive episode within 1 year are diagnosed with this o No longer in DSM 5 o Specifier for Bipolar I II 6 What are the prevalence rates and course of Bipolar Disorders lecture textbook Bipolar disorder is less common than depressive disorders 0 6 will experience I and 0 4 will experience II in lifetime Men and women are equally as likely to be diagnosed No consistent differences in the prevalence of the disorder among ethnic groups or across cultures o Suggests that biological factors may be more responsible for bipolar disorder than for depressive disorder Late adolescence or early adulthood Most people don t receive treatment 7 How do you distinguish between unipolar depression and bipolar disorders lecture textbook Unipolar Depression Unipolar mood disorders major depression dysthymia Double depression major depression dysthymia Women are 2X more likely to experience depression than men Diathesis stress model Bipolar Disorders Bipolar disorders include manic hypomanic or mixed episodes Hypomanic episodes are less severe than manic episodes Men Women have similar rates of Bipolar Disorder High genetic component Medication and psychotherapy both effective treatments Effective treatment with medication 8 How do biological and psychological theories
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