Mood Disorders (Depressive and Bipolar) – PSYC3102 Lecture Review

A comprehensive set of question-and-answer flashcards covering definitions, epidemiology, diagnostic criteria, course, prognosis, aetiology, and treatments for depressive and bipolar mood disorders, based on Professor Gen Dingle’s PSYC3102 lecture.

In the APA’s terminology, what is defined as a state of arousal characterised by subjective feelings such as sadness or joy?

Emotion

What word is used for the observable pattern of emotional expression (e.g., ‘blunted’ facial expression)?

Affect

Which term refers to a sustained emotional state used in psychiatric diagnosis?

Mood

Name the three main categories of mood disorders covered in DSM-5.

Major depressive disorder, bipolar disorders, and related/other depressive disorders

Globally, approximately how many people were living with depression in 2019 (WHO)?

About 280 million people

What is the lifetime prevalence risk for major depressive disorder (MDD)?

Roughly 16 %

Which sex shows higher prevalence rates for major depressive disorder?

Females

What is the combined lifetime prevalence risk for Bipolar I and II disorders?

Approximately 4 %

Which mood disorder shows equal prevalence in males and females?

Bipolar disorder

What is one key diagnostic criterion that must never have occurred in order to diagnose Major Depressive Disorder?

A manic or hypomanic episode

How long must symptoms last to qualify as a Major Depressive Episode?

At least two consecutive weeks

How many total symptoms (and which two key ones) are required for a Major Depressive Episode?

Five or more symptoms, with at least depressed mood or loss of interest/pleasure

Give two biological conditions that can mimic depressive symptoms and must be ruled out in differential diagnosis.

Parkinson’s disease and stroke (others include dementias, epilepsy, tumours)

What former name did Persistent Depressive Disorder go by?

Dysthymia

For how long must depressed mood be present most days to diagnose Persistent Depressive Disorder?

At least 2 years with no break longer than 2 months

List any two of the six supporting symptoms for Persistent Depressive Disorder.

Examples: poor appetite or overeating; insomnia or hypersomnia; low energy/fatigue; low self-esteem; poor concentration/indecisiveness; feelings of hopelessness

How many symptoms (total) must be present for Premenstrual Dysphoric Disorder and when?

At least five symptoms in the final week before menses, improving after onset and minimal the week post-menses

What percentage of people with an initial MDD diagnosis develop mania 6–10 years later?

About 5–10 %

Name two factors that increase risk of depression recurrence.

History of multiple previous episodes; co-existing alcohol/drug use disorder; persistent depressive disorder; anxiety symptoms

What single event is sufficient for a DSM-5 diagnosis of Bipolar I Disorder?

At least one manic episode

How long must a manic episode last (if not hospitalised) to meet DSM-5 duration criteria?

At least 1 week

List three characteristic symptoms of mania.

Inflated self-esteem, decreased need for sleep, pressured speech, flight of ideas, distractibility, psychomotor agitation, risky pleasurable activities (any three)

How does a hypomanic episode differ from a manic episode in duration and severity?

Lasts at least 4 days and is not severe enough to cause marked impairment, hospitalisation, or psychosis

Which bipolar subtype requires at least one hypomanic and one major depressive episode but no manic episode?

Bipolar II Disorder

What is the approximate age of onset for bipolar disorder?

Around 18–22 years

Give two good prognosis indicators for bipolar disorder.

Short duration of manic episodes; older age at onset; few suicidal thoughts; few co-existing psychiatric/medical problems

Which mood disorder—bipolar or unipolar depression—has higher rates of suicide attempts?

Bipolar disorder

What percentage of people with co-morbid MDE and Borderline Personality Disorder in Söderholm et al. (2020) had attempted suicide?

About 60 %

What family study finding supports a genetic contribution to Bipolar Disorder?

50–60 % of bipolar patients have a family history of mood disorder

What heritability estimate is derived from twin studies for Bipolar Disorder?

Approximately 80 %

Which neurotransmitter is central to the Catecholamine Hypothesis of mood disorders?

Noradrenaline (norepinephrine)

According to the Indolamine Hypothesis, deficiency in which neurotransmitter is linked to depression?

Serotonin

Which behavioural theory argues depression results from a reduction in response-contingent positive reinforcement?

Lewinsohn’s behavioural theory

In Seligman’s Learned Helplessness model, what attributional style most increases depression risk?

Personal, global and stable attributions for negative events

Name the three components of Beck’s cognitive triad.

Negative views about oneself, the world, and the future

What four interpersonal problem areas are targeted by Interpersonal Psychotherapy (IPT)?

Grief, role disputes, role transitions, interpersonal deficits

Which class of antidepressant medications is currently most frequently prescribed?

Selective Serotonin Reuptake Inhibitors (SSRIs)

List two common side-effects of antidepressants.

Dry mouth, sexual dysfunction, constipation, urinary retention, hypertension (any two)

What notable risk exists when prescribing antidepressants to bipolar patients?

They may provoke a manic episode

What did the NIMH Treatment of Depression study conclude about CBT, IPT and medication efficacy?

CBT, IPT and tricyclic medication were equally effective for acute depression

Which mood disorder medication requires regular serum level monitoring due to toxicity concerns?

Lithium

State two common side-effects of lithium therapy.

Weight gain, tremor, nausea, polyuria/polydipsia, memory problems, impaired coordination (any two)

Approximately what proportion of bipolar patients respond well to lithium?

About 60 %

What percentage of bipolar and cyclothymic patients show non-compliance with lithium?

Roughly 57 %

Name three typical components of a CBT program for depression.

Psychoeducation, thought records/mood diaries, activity scheduling, sleep hygiene (any three)

Swartz & Swanson (2014) showed that CBT plus pharmacotherapy has what effect on bipolar disorder outcomes compared with treatment as usual?

Reduces relapse rates, improves functioning and symptom severity, and is cost-effective

In Dingle et al. (2010), what biological marker decreased in responders to combined CBT + medication?

Urinary metadrenaline levels

What social factor did Cruwys et al. (2013) find protects against future depression and relapse?

Multiple social group memberships / strong social connections

Lewinsohn identified three pathways to reduced reinforcement. Give one.

Loss of rewarding events in environment; lack of requisite skills; inability to experience reinforcement

According to life-events research, which two types of events often precede bipolar episodes?

Schedule-disrupting events and goal-attainment events