abnormal.lecture12.2025

Adult Psychopathology

• Presenter: Dr. Simon B. Sherry, Professor at Dalhousie University and Psychologist at CRUX Psychology.

Treatment Overview

General Statistics

• Major Depression Recovery:

  • 60% of individuals with major depression benefit from psychotherapy (Comer, 2010).

  • Commonly, treatment spans 25 one-hour sessions over 25 weeks.

  • The combination of psychotherapy and antidepressants results in a 10% increased recovery rate (Hollon et al., 2002).

  • High relapse rates (>50%) are present post-treatment (Barlow et al., 2006).

Treatment Modalities for Major Depression

• Behavioral Therapy

• Cognitive-Behavioral Therapy (CBT)

• Interpersonal Therapy

• Psychodynamic Therapy

• Mood disorders show a higher positive response to treatment than other psychological conditions.

Case Analysis

Case Study: Interpersonal Loss

• Profile: Male, late 40s, tradesperson with Major Depressive Disorder (MDD), undergoing divorce, potential attachment disturbance.

Unipolar Depression Treatments

• Approximately one-third of individuals with unipolar depression enter treatment yearly.

Psychological Approaches:

• Behavioral Therapy

  • Developed by Lewinsohn in the 1970s, emphasizes the link between mood and life rewards.

  • Focuses on reintroducing enjoyable activities, reinforcing positive behaviors, and social skills development.

• Cognitive Therapy

  • Proposed by Beck, indicates that negative thinking patterns lead to depression.

  • Combats maladaptive attitudes and addresses the cognitive triad: negative views of self, world, and future.

  • Treatment involves recognizing and changing these cognitive distortions across four phases.

Preventing Relapse

• Mindfulness-Based Cognitive Therapy (MBCT): Teaches disengagement from negative thinking, shown to reduce relapse rates.

• Cumulative Data: Curves show significant difference in relapse rates between MBCT and treatment-as-usual.

Reasons for Combined Treatments

• Combining drug treatments with psychosocial interventions often leads to better outcomes in severe depression cases.

• Individual treatment preferences may dictate the optimal approach.

Biological Approaches to Depression

• Common biological treatments:

  • Antidepressants, often involving Tricyclics, MAOIs, and SSRIs.

• Electroconvulsive Therapy (ECT): Effective for severe cases when drugs fail.

• Transcranial Magnetic Stimulation and Brain Stimulation are alternatives when traditional approaches do not work.

Antidepressant Medication Details

• Nearly 70% of major depression patients utilize antidepressants, showing a 60% effectiveness rate (Comer, 2010).

• Following treatment cessation within four months, relapse rates exceed 50% (Barlow et al., 2006).

• Canada has seen a dramatic increase in antidepressant use from 3.2 million to 14 million between 1981 and 2000.

MAO Inhibitors Risks

• Serious interactions with tyramine-rich foods can cause dangerously high blood pressure.

• New formulations such as skin patches mitigate some side effects associated with traditional MAOIs.

Tricyclics Overview

• Clinical studies show a majority of patients benefit significantly when adhering to treatment plans longer than a few weeks.

• The risk of relapse is notably reduced with extended use (‘continuation therapy’).

SSRIs Overview

• Selective Serotonin Reuptake Inhibitors (SSRIs): Designed to work specifically on serotonin receptors, these drugs show favorable safety profiles compared to earlier antidepressants.

Comparison of Treatments for Unipolar Depression

• Cognitive, cognitive-behavioral, interpersonal, and biological therapies are all effective for various degrees of depression severity.

• Maintenance of therapeutic benefits is crucial as none are entirely relapse-proof.

Lifestyle Considerations for Treatment

• Effective self-monitoring, medication compliance, and social support are fundamental in preventing relapse.

• Lifestyle modifications and booster sessions can aid in sustained management of depressive symptoms.

Treatments for Bipolar Disorder

Historical Context

• Prior to recent advancements, treatment options were limited and often ineffective, with high relapse rates.

Current Treatments

• Lithium and mood-stabilizing drugs provide significant relief, though close monitoring is necessary to avoid toxicity.

• Adjunctive Psychotherapy is used due to the insufficient response from medication alone in many patients.

  • This therapy incorporates aspects like medication management and social skills training.

Interpersonal and Social Rhythm Therapy

• Daily logs are utilized to track social activities to promote rhythm stability, which is vital in managing bipolar disorders.

This structured approach to treatment offers a comprehensive understanding of various therapies for mood disorders, underlining the importance of individualization and multifaceted treatment plans.