psychopathology lec 2- depression + bipolar disorder

What is the difference between emotion and mood?

Emotion is short (seconds-minutes) and tied to a specific stimulus. Mood is longer (hours-days) and is a general affective state.

What is anhedonia?

The inability to feel pleasure from activities usually found enjoyable.

What is the difference between transference and projection?

Transference: redirecting feelings from past relationships onto current ones. Projection: attributing one's own unwanted feelings to someone else.

What characterizes a mood disorder?

Discrete periods where behavior is dominated by extremely low (depressed) or high (manic) moods.

What are the two core symptoms required for Major Depressive Disorder (MDD)?

Depressed mood OR anhedonia (loss of pleasure).

Name 5 symptoms of Major Depressive Disorder.

Depressed mood, anhedonia, sleep changes, appetite/weight changes, fatigue, worthlessness, concentration problems, psychomotor changes, suicidal thoughts.

What is Disruptive Mood Dysregulation Disorder (DMDD)?

A childhood disorder (ages 6-18) with severe temper outbursts ≥3x/week and persistent irritability between outbursts.

What is Premenstrual Dysphoric Disorder (PMDD)?

Severe emotional/physical symptoms before menstruation, affecting 2-5% of women.

What is the lifetime prevalence range for MDD?

4-25% (varies by study).

What is the gender ratio for depression?

Women are twice as likely as men to experience depression (women = ~70% of cases).

At what age do 50% of people experience their first depressive symptoms?

Age 26 (median age of onset).

How does depression affect mortality risk?

People with unipolar depression have twice the mortality risk of the general population.

What does the monoamine hypothesis propose?

Depression is caused by low levels of serotonin, norepinephrine, and dopamine.

What is the permissive hypothesis?

Low serotonin allows other neurotransmitters to fluctuate more widely, increasing vulnerability to mood swings.

What is the current view on the "chemical imbalance" theory of depression?

It is controversial and oversimplified; evidence is not strong (per Moncrieff et al., 2022 review).

How does the HPA axis relate to depression?

Chronic stress → HPA dysregulation → high cortisol → impaired hippocampal neurogenesis → depression.

What is learned helplessness?

Believing one has no control over their environment, leading to passive acceptance of negative outcomes (Seligman).

What is Beck's negative cognitive triad?

Negative views of: 1) Self, 2) World, and 3) Future.

What are the three components of depressive attributional style?

Internal ("my fault"), Stable ("will always be this way"), Global ("affects everything").

What is behavioral activation?

A treatment that increases engagement in rewarding activities to counteract depression (TRAP → TRAC model).

What are the four main classes of antidepressants?

SSRIs, TCAs, MAOIs, SNRIs.

What percentage of patients benefit from antidepressants?

~50% benefit, but only ~25% achieve normal functioning.

What is Interpersonal Psychotherapy (IPT)?

Brief therapy focusing on improving relationships, role transitions, and interpersonal disputes.

What is Dynamic Interpersonal Therapy (DIT)?

16-session psychodynamic therapy focusing on attachment threats and mentalizing (understanding self/others).

What is the key difference between Bipolar I and Bipolar II?

Bipolar I includes manic episodes; Bipolar II includes hypomanic + major depressive episodes.

List 3 symptoms of a manic episode.

Grandiosity, reduced need for sleep, racing thoughts, distractibility, increased activity, impulsivity.

What is the first-line medication for bipolar disorder?

Lithium carbonate (mood stabilizer).

What is rapid cycling?

≥4 mood episodes within 12 months; more severe and treatment-resistant.

What is the NICE definition of self-harm?

"Any act of self-poisoning or self-injury, irrespective of apparent purpose."

How much does self-harm increase suicide risk in the following year?

50-100 times higher than general population.

Name 3 risk factors for suicide.

Male gender, previous self-harm, mental illness, unemployment, social isolation, access to means.

True or False: Asking someone if they're suicidal can give them the idea.

False. Asking directly reduces risk by opening communication.

What does IMV stand for?

Integrated Motivational-Volitional model of suicide.

What are the three phases of the IMV model?

1) Pre-motivational (background), 2) Motivational (ideation develops), 3) Volitional (transition to action).

What is entrapment in the IMV model?

Feeling trapped with no escape from pain—key in developing suicidal thoughts.

What are volitional moderators in the IMV model?

Factors that move thoughts to action: access to means, impulsivity, fearlessness about death, pain tolerance.

What is suicide contagion?

Increased suicide risk after exposure to suicide (media, peer).

What is the most effective treatment for severe

medication-resistant depression?,Electroconvulsive Therapy (ECT).

What is mentalizing?

Ability to reflect on one's own mental states and understand others' perspectives.

Which gender attempts suicide more vs. dies by suicide more?

Women attempt more; men die by suicide more (due to more lethal methods).

What is the main duration difference between manic and hypomanic episodes?

Manic: ≥1 week. Hypomanic: ≥4 days.

What is the main severity difference between manic and hypomanic episodes?

Manic: severe impairment, may include psychosis. Hypomanic: mild/moderate, no major impairment or psychosis.

Which episode may require hospitalization?

Manic episodes often require hospitalization; hypomanic episodes do not.

Which bipolar diagnosis includes hypomanic but not manic episodes?

Bipolar II Disorder.