Abnormal Psychology Ch 7 (Barlow) - Mood Disorders and Suicide

Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure

Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day

Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body weight in a month), or decreased or increase in appetite nearly every day

Insomnia or hypersomnia nearly every day

Psychomotor agitation or retardation nearly every day (observable by others)

Fatigue or loss of energy nearly every day

Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day

Diminished ability to think or concentrate, or indecisiveness, nearly every day

Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms cause clinical significant distress or impairment in social, occupational, or other important areas of functioning

C. Episode not attributable to physiological effects of a substance or other medical condition

Manic Episode

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary

B. During the period of mood disturbance and increased energy or activity, three or more of the following symptoms (four if mood is only irritable) are present to a significant degree and represent a noticeable change from usual behaviour:

Inflated self-esteem or grandiosity

Decreased need for sleep

More talkative than usual or pressure to keep talking

Flight of ideas or subjective experience that thoughts are racing

Distractibility (reported or observed)

Increase in goal-directed activity or psychomotor agitation

Excessive involvement in activities that have a high potential for painful consequences

C. Mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features

D. Episode not attributable to the physiological effects of a substance

3-methoxy-4-hydroxy-phenylglycol (MHPG)

By-product of norepinephrine. Depressed patients with lower levels of MHPG respond better to tricyclic antidepressants than those with higher levels.

altruistic suicide

Formalized suicide approved of and even expected by some cultures.

anomic suicide

Suicide motivated by loss and confusion caused by a major life disruption.

atypical depressive episode

Depressive episode characterized by some ability to experience interest and pleasure, increased anxiety, overeating, and oversleeping.

carbamazepine

Antiseizure medication sometimes effective in treating bipolar disorder.

catatonic depressive episode (depressive stupor)

Rare but severe mood disorder depressive episode usually featuring substantial reduction in spontaneous motor movement or, on occasion, agitation or odd mannerisms.

catecholamine hypothesis

Outdated, simplistic theory of mood disorder etiology stating that norepinephrine (a catecholamine) excess causes mania, and that low levels of it cause some forms of depression.

circadian rhythm sleep disorder

Sleep disturbance resulting in sleepiness or insomnia, caused by the body's inability to synchronize its sleep patterns with the current pattern of day and night.

cognitive restructuring

Cognitive therapy procedure used to change negative or unrealistic thoughts or attributions.

cortical immaturity hypothesis

Theory that the behavior and arousal levels of psychopaths result from incomplete development of the cerebral cortex.

depressive personality disorder

Pervasive pattern dominated by dejection, self-criticism, and a judgmental stance toward other people; under consideration as a future DSM category.

dexamethasone suppression test (DST)

Proposed biological test for depression; the test failed to discriminate depression from other disorders, however.

dysfunctional attitudes

Cognitive errors seen in depressed individuals, who may automatically assume the worst, draw negative conclusions arbitrarily, and treat minor problems as major ones.

dysphoric manic or mixed episode

See mixed manic episode.

dysthymic disorder

Mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism or despair, present for at least 2 years, with no absence of symptoms for more than 2 months.

egoistic suicide

Suicide that occurs in the context of diminished social supports, as in the case of some elderly persons who have lost friends and family contacts.

fatalistic suicide

Suicide in the context of a person's hopelessness and loss of the feeling of control over his or her own destiny.

indoleamine hypothesis

Outdated, simplistic theory that low levels of serotonin (one of the indoleamines) might cause depression.

interpersonal therapy

Brief, structured treatment that focuses on teaching a person skills to improve existing relationships or develop new ones.

lithium carbonate

Common salt used in substantial doses to treat bipolar disorder. Clients often discontinue its use because they enjoy the manic periods, and relapse rates are high. The mechanism for its effects is unknown.

longitudinal course specifiers

Time patterns among mood disorders (e.g., prior dysthymia or cyclothymia rapid cycling, seasonal patterns) that may suggest their course, treatment, and prognosis.

major depressive disorder, single or recurrent episode

Mood disorder involving one (single episode) or more (separated by at least two months without depression—recurrent) major depressive episodes.

marital therapy

Interventions for the relationship problems of couples, whether married or not.

melancholic (endogenous) depressive episode

Mood disorder depressive episode associated with more severe somatic disturbances such as anhedonia, loss of sex drive, or weight loss.

mixed manic episode

Condition in which the individual experiences both elation and depression or anxiety at the same time. Also known as dysphoric manic episode.

monoamine oxidase (MAO) inhibitors

Medications that treat depression and severe social anxiety by blocking an enzyme that breaks down the neurotransmitters norepinephrine and serotonin.

mood congruent

Consistent with the person's emotional level. Hallucinations and delusions may be congruent or incongruent with a depressed person's mood.

mood incongruent

Not consistent with the person's emotional level. Psychotic symptoms associated with mood disorders may not be congruent with the person's mood.

pathological or impacted grief reaction

Extreme reaction to the death of a loved one that involves psychotic features, suicidal ideation, or severe loss of weight or energy, or that persists more than 2 months.

permissive hypothesis

Theory that neurotransmitter systems contribute to mood irregularities when low serotonin levels permit them to range widely and become unregulated.

phototherapy

Treatment of seasonal affective disorder with large doses of exposure to bright light.

postpartum onset

Disorder that first appears in mothers during the time immediately following childbirth.

psychotic depressive episode

Condition in which psychotic symptoms such as delusions and hallucinations accompany depressive episodes.

psychotic symptoms

Delusions and hallucinations that may appear during depressive or manic episodes.

rapid cycling pattern

Temporal course of a bipolar disorder when transitions between mania and depression are quick, occurring four or more times in one year.

relapse

Reappearance of or return to problem behaviors after treatment or recovery.

Schedule for Affective Disorders and Schizophrenia (SADS)

Specialized semistructured interview protocol that specifically assesses mood and schizophrenic disorders.

seasonal patterning

Temporal course of bipolar or recurrent major depressive disorders in which episodes occur during particular seasons of the year.

selective serotonergic reuptake inhibitors (SSRIs)

Class of medications for depression (including Prozac) that act on the serotonergic system by inhibiting the reuptake of the neurotransmitter serotonin.

serotonin reuptake blockers

See selective serotonergic reuptake inhibitors.

specifiers in mood disorders

Patterns of characteristics that sometimes accompany major depressive or manic episodes and may help predict their course and prognosis. These include psychotic, melancholic, atypical, catatonic, chronic, and with postpartum onset.

Mood Disorders

Group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression.

Major Depressive Episode

Most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and inability to experience pleasure, persisting at least 2 weeks.

Mania

Period of abnormally excessive elation or euphoria, associated with some mood disorders.

Hypomanic Episode

Less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders.

Mixed Features

Condition in which the individual experiences both elation and depression or anxiety at the same time. Also known as dysphoric manic episode or mixed manic episode.

Major Depressive Disorder

Most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and inability to experience pleasure, persisting at least 2 weeks.

Persistent Depressive Disorder (dysthymia)

Mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair, present for least 2 years, with no absence of symptoms for more than 2 months.

Double Depression

Severe mood disorder typified by major depressive episodes superimposed over a background of persistent dysthymic mood. Also called "persistent depressive disorder with intermittent major depressive episodes".

Hallucinations

Psychotic symptoms of perceptual disturbance in which things are seen, heard, or otherwise sensed although they are not actually present.

Delusion

Psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality.

Catalepsy

Motor movement disturbance seen in people with some psychoses and mood disorders in which body postures are waxy and can be "sculpted" to remain fixed for long periods.

Seasonal Affective Disorder (SAD)

Mood disorder involving a cycling of episodes corresponding to the seasons of the year, typically with depression occurring in the winter.

Integrated Grief

Grief that evolves from acute grief into a condition in which the individual accepts the finality of a death and adjusts to the loss.

Complicated Grief

Grief characterized by debilitating feelings of loss and emotions so painful that a person has trouble resuming a normal life; designated for further study as a disorder by DSM-5.

Premenstrual Dysphoric Disorder

Disruptive Mood Dysregulation Disorder

Condition in which a child has chronic negative moods such as anger and irritability without any accompanying mania.

Bipolar II Disorder

Alternation of major depressive episodes with hypomanic episodes (not full manic episodes).

Bipolar I Disorder

Alternation of major depressive episodes with full manic episodes.

Cyclothymic Disorder

Chronic (at least 2 years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes.

Neurohormones

Hormones that affect the brain and are increasingly the focus of study in psychopathology.

Learned Helplessness Theory of Depression

Martin Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they do in reality).

Depressive Cognitive Triad

Thinking errors in depressed people negatively focused in three areas; themselves, their immediate world, and their future.

Mood-Stabilizing Drug

Medication used in the treatment of mood disorders, particularly bipolar disorder, that is effective in preventing and treating pathological shifts in mood.

Electroconvulsive therapy (ECT)

Biological treatment for severe, chronic depression involving the application of electrical impulses through the brain to produce seizures. The reasons for its effectiveness are unknown.

Cognitive Therapy

Treatment approach that involves identifying and altering negative thinking styles related to psychological disorders such as depression and anxiety and replacing them with more positive beliefs and attitudes and, ultimately, more adaptive behavior and coping styles.

Interpersonal Psychotherapy (IPT)

Brief treatment approach that emphasizes resolution of interpersonal problems and stressors, such as role disputes, marital conflicts or forming relationships in marriage or a new job. It has demonstrated effectiveness for such problems as depression.

Maintenance Treatment

Combination of continued psychosocial treatment, medication, or both designed to prevent relapse following therapy.

Suicidal Ideation

Serious thoughts about committing suicide.

Suicidal Plans

The formulation of a specific method of killing oneself.

Suicidal Attempts

Efforts made to kill oneself

Psychological Autopsy

Postmortem psychological profile of a suicide victim constructed from interviews with people who knew the person before death.

Bipolar II Disorder - Diagnostic Criteria

A. Criteria have been met for at least one hypomanic

episode and at least one major depressive episode.

Criteria for a hypomanic episode are identical to those

for a manic episode (see DSM-5 Table 7.2), with the

following distinctions:

1) Minimum duration is 4 days;

2) Although the episode represents a defnite change

in functioning, it is not severe enough to cause marked

social or occupational impairment or hospitalization;

3) There are no psychotic features.

B. There has never been a manic episode.

C. The occurrence of the hypomanic episode(s) and major

depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specifed or unspecifed schizophrenia spectrum and other psychotic disorder.

D. The symptoms of depression or the unpredictability

caused by frequent alternation between periods of

depression and hypomania causes clinically signifcant

distress or impairment in social, occupational, or other

important areas of functioning.

Specify current or most recent episode:

Hypomanic: If currently (or most recently) in a hypomanic

episode

Depressed: If currently (or most recently) in a major depressive episode

Specify if:

With anxious distress

With mixed features

With rapid cycling

With mood-congruent psychotic features

With mood-incongruent psychotic features

With catatonia

With peripartum onset

With seasonal pattern

Specify course if full criteria for a mood episode are not

currently met:

In full remission, in partial remission

Specify severity if full criteria for a mood episode are

currently met:

Mild, moderate, severe