Anxiety and mood disorders

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22 Terms

1

What are the symptoms of MDD

  • Persistent sad mood (has to be one of the symptoms)

  • Lack of pleasure aka. Anhedonia (has to be one of the symptoms)

  • Weight gain or loss

  • Sleep gain or loss (insomnia vs. Hypersomnia)

  • Fatigue

  • Suicidal thoughts

  • Agitation or 'retardation' - restless or slow

  • Recurrent thoughts of guilt /worthlessness

  • Diminished ability concentrate

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2

What are the 8 depressive disorders in the DSM-5?

  1. Disruptive mood regulation disorder

  2. Major depressive disorder

  3. Persistent depressive disorder (dysthymia)

  4. Premenstrual dysphoric disorder

  5. Substance / medication induced depressive disorder

  6. Depressive disorder due to another medical condition

  7. Other specified depressive disorder

  8. Unspecified depressive disorder

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3

What are the symptoms of dysthymia (persistent depressive disorder)?

  • Poor appetite / overeating

  • Insomnia/ hypersomnia

  • Fatigue

  • Low self-esteem

  • Poor concentration indecisiveness

  • Sense of hopelessness

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4

What is the course of MDD??

  • Can begin at any age, but onset increases significantly with puberty

  • Peak onset is 20's

  • People can go 2 or more months with no symptoms or years without experiencing an episode

  • Most people experience spontaneous recovery (recover without intervention) -for 4 of 5 people, this will happen within 12 months

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5

What are factors associated with lower rates of recovery for MDD?

  • Symptom severity

  • Personality disorders

  • Psychotic features

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6

What are factors associated with an increased risk of an episode of MDD?

  • Severity of previous episode

  • Being younger at onset

  • More prior episodes

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7

What is the course of persistent depressive disorder (dysthymia)?

  • Early and chronic onset

  • Some people rarely experience remission

  • Symptoms will return at a lower level

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8

What is the prevalence of depressive disorders?

  • prevalence in adults is 6-7% (Aus and US)

  • 12 month prevalence rate for dysthymia is 0.5%

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9

What are the implications in the aetiology of depressive disorders?

  • Disruption in neurotransmitter functioning

  • Genetic risk

  • Childhood trauma,abuse or neglect

  • Incidence of negative life events

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10

What is the cognitive behavioural model of depression?

Made up of 2 components:

  1. Behavioural component - suggest that depression is maintained by a lack of positive reinforcement - feeds into a sense of learned helplessness in relation to external environment

  2. Cognitive component - suggests that depression is about cognitive thoughts relating to the self, the world and the future -pessimism

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11

What is used to treat depressive disorders?

  • Ants depressant medications

  • SSRI's ( selective serotonin reuptake inhibitors) -most prescribed class of anti-depressants

  • ECT ( electroconvulsive therapy)

  • Biological treatment used as a last resort

  • Psychological interventions - CBT (cognitive behavioural therapy) and IPT ( interpersonal therapy)

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12

What are the key strategies in CBT for depression?

Behavioural activation aka pleasant events scheduling - targets symptom of anhedonia (loss of pleasure/ interest)

Engage in previously enjoyed activities - positive reinforcement

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13

Cognitive restructuring

Help clients identify negative thoughts relating to sadness and hopelessness -evaluate evidence for and against these thoughts

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14

What are the 10 anxiety disorders in the DSM-5?

  1. Separation anxiety disorder

  2. Selective mutism

  3. Specific phobia

  4. Social anxiety disorder (social phobia)

  5. Panic disorder

  6. Agoraphobia

  7. Generalised anxiety disorder

  8. Substance/ medication induced anxiety disorder

  9. Anxiety disorder due to another medical condition

  10. Other specified anxiety disorder

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15

What are the 3 systems of anxiety?

  1. Cognitive - what people think during anxiety -provoking situations

  2. Behavioural- action taken when feeling anxious

  3. Psychological - bodily responses to anxiety

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16

What are the symptoms of specific phobia?

  • Extreme fear: fear that is disproportionate to the actual threat -specifically related to the identified object or situation

  • Avoidance behaviour

  • duration and impact:

    • Persist for 6 months or longer

    • Causes significant stress / interference in daily functioning

    • Symptoms cannot be better explained by another condition

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17

Diagnostic criteria for generalised anxiety disorder (GAD)

  • 6 months

  • Worry is difficult to control

  • At least 3 of 6 physiological symptoms present (muscle tension, restlessness, fatigue, difficulty concentrating, irritability and sleep disturbances

  • Distress and impairment

  • Exclusion criteria

  • Individuals with GAD also often exhibit hyper-vigilance

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18

What are the symptoms of panic disorder?

  • Palpitations, pounding heart, accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Shortness of breath

  • Feelings of choking

  • Chest pain/discomfort

  • Nausea or abdominal pain

  • Dizziness, lightheadedness

  • Chills or heat sensations

  • Derealisation

  • Depersonalisation

  • Numbness or tingling

  • fear of loosing control / going crazy

  • Fear of dying

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19

Comorbidity

Simultaneous presence of more than one diagnose in an individual

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20

Implications in the aetiology of anxiety disorders

  • Stressful life events

  • Genetic influence

  • Temperament

  • Exposure to traumatic events

  • Parenting behaviours

  • Interaction between biological and environmental factors

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21

Stanley Rackmann's Pathways to Fear Development

  • Direct experience: personal negative experiences - conditioning

  • Instructional learning: warnings from others, particularly caregivers

  • Vicarious learning: observing significant others behaving fearfully

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22

Interventions for anxiety disorders

  • psychoeducation about anxiety -use of a cognitive behavioural model

  • cognitive restructuring - ABC model

  • Behavioural strategies - exposure hierarchy

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