Psychopathology Weekly Notes
Psychopathology Weekly Notes 20732
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This page Class Notes was uploaded by Kenedy Ramos on Sunday February 14, 2016. The Class Notes belongs to 20732 at Gonzaga University taught by Dr. Fernandez in Spring 2016. Since its upload, it has received 34 views. For similar materials see Psychopathology in Psychlogy at Gonzaga University.
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Date Created: 02/14/16
Psychopathology Notes Week 2 Depressive Disorders Types of Depressive Disorders Major depressive disorder persistent depressive disorder disruptive mood dysregulation disorder premenstrual dysphoric disorder depressive disorder due to another medical condition example hypothyroidism other speci edunspeci ed depressive disorder Maior Depressive Disorder Criteria that needs to be met A 5 symptoms present during the same 2 week period and represents change from prior function at least 1 sxs is either 1 or 2 a Depressed mood of day nearly every day in kids may be irritable b Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day Signi cant weight loss or gain or change in appetite nearly every day Insomnia or hypersomnia nearly every day Psychomotor agitation or retardation nearly every day Fatigue or loss of energy nearly every day Feelings of worthlessness o excessiveinappropriate guilt nearly every day Diminished ability to think or concentrate or indecisiveness nearly every day Recurrent thoughts of suicide recurrent suicidal ideation without a speci c plan or a suicide attempt or a speci c plan for committing suicide B st cause clinically signi cant distress or impairment in functioning C Episode not attributable to effects of substance or GMC a A C represent a Major Depressive Episode D Episode is not better explained by schizoaffective disorder SX schizophreniform delusional disorder or other speci ed and unspeci ed SX spectrum or other psychotic disorders E There has never been a manic or hypomanic episode n Demographics Life prevalence is around 712 of men and 2025 of women High comorbidity with anxiety disorders 36 and personality disorders 37 Mortality is high 46 with to die 9 report suicide attempt risk of suicide death is 20x higher than nondepressed people Persistent Depressive Disorder Criteria that needs to be met A Depressed mood most of day more days than not as indicated by either subjective account or observation by others for a least 2 years a For kidsadolescents mood can be irritable and duration for 1 year B While depressed 2 of the following symptoms need to occur a Poor appetite or overeating insomniahypersomnia low energy or fatigue low selfesteem poor concentration or dif culty making decisions feelings of hopelessness C Has never been without symptoms for more than 6 months at a time D Criteria for PDD may be continuously present for 2 years E Needs to cause a clinically signi cant distress or impairment More on Mood Disorders Double depression Major depressive episodes PDD rst severe psychopathology poor course Disruptive Mood Dvsreoulation Disorder Include children with chronic irritability anger aggression hyperarousal and frequent temper tantrums quotGrosslyquot out of proportion for the situation inconsistent with developmental level outbursts occur on average about 3 ties a week mood between outbursts persistently irritable or angry most of the day nearly every day No evidence of periods of elevated mood like mania can be diagnosed Differs from ADHD intense negative affect driving irritability Needs to be between the ages of 6 and 18 Bipolar and Related Disorders Bipolar l Disorder Bipolar ll Disorder Cyclothymic Disorder Bipolar and Related Disorder due to another medical condition other speci edunspeci ed bipolar and related disorder Bipolar I There has been at least one manic episode which may have been preceded by and may be followed by hypomanic or major depressive episodes Bipolar ll De ned by the presence of recurrent depressive episodes and one or more hypomanic episodes Manic Episode A Distinct period of abnormally and persistently elevated expansive or irritable mood and persistently increased goaldirected activityenergy lasting at least one week and present most of the day nearly every day B 3 of the following or 4 if mood is inly irritable are present to a signi cant degree and represent noticeable change from usual behavior a Increased selfesteem or grandiosity decreased need for sleep more talkativepressured speech ight of ideasthoughts racing distractibility increase in goaldirected activity or psychomotor agitation excessive involvement in activities that have high potential for painful consequences C Marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others or psychotic features D Not due to substance or medical condition Hvoomanic Episode A Distinct period of abnormally and persistently elevated expansive or irritable mood and abnormay and persistently increased activity or energy sating 4 consecutive days and present most of the day nearly every day B 3 or 4 if mood is only irritable have persisted represent a noticeable change from usua behavior and have been present to a signi cant degree a In ated selfesteem or grandiosity decreased need for sleep more talkative than usual or pressure to keep talking ight of ideas or subjective experience that thoughts are racing distractibility increased in goal directed activity or psychomotor agitation excessive involvement in risky pleasurable activities Associated with an unequivocal change in functioning that is uncharacteristic The disturbance in mood and change is functioning is observable by others Episode is severe enough to cause marked impairment in functioning or to necessitate hospitalization F Not attributable to the physiological effects of a substance WU Bipolar I Disorder A Criteria met for a least one manic episode B Not better explained by schizoaffective disorder SX schizophreniform disorder deusiona disorder or other SX spectrumpsychotic disorder a Speci ers i Mild few if any sxs in excess of criteria intensity distressing but manageable minor impairment in functioning ii Moderate of sxs intensity and impairment between mild and severe iii Severe substantially in excess of criteria intensity seriously distressing and unmanageable markedly interfere with functioning iv With psychotic features most recent episode manic most recent episode others in partial remission in full remission unspeci ed also with anxious distress mixed features rapid cycling melancholic features peripartum onset seasonal pattern Bipolar ll Disorder A Need to meet criteria for a current or past hypomanic and a current or past major depressive episode E st of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically signi cant distress or impairment Spec cy a Current of most recent episode hypomanicdepressed b If with anxious distress mixed featuresperipartum onset etc c If in partial remission full remission Severity mild Moderate Severe Other facts a Not a milder illness than Bipolar l often accompanied by more severe depressions more chronicity and more suicidal behavior than bipolar l b 08 prevalence average mids 20 s 515 of cases progress to bipolar l c Suicide 2433 lifetime attempt completed suicide higher than bipolar l d Highest among relatives with bipolar II as opposed to individuals with bipolar l more education fewer yrs of illness and being married associated with functional recovery e Comorbidity 60 have 3 mental disorders AD 75 SUD 37 14 at least one lifetime eating disorder In children a Caution of diagnosing children dif cult to de ne with precision what is quotnormalquot or quotexpectedquot at any given age Therefore judge according to child s own baseline b ADHD many overlapping sxs such as rapid speech racing thoughts distractibility and less need for sleep Clarify whether sxs represents a distinct episode c lrritability when persistent and particularly severe dx of DMDD would be more appropriate d Essential that sxs represent a distinct change from child39s typical behavior Cvclothvmic Disorder A B For at least 2 years there have been numerous periods with hypomanic sxs and depressive sxs that do not meet criteria for an episode Periods present for at least half of the time and individual not without sxs for 2 months at a time MD manic or hypomanic episode criteria never met a Comorbid with SUC sleep disorders or ADHD Family studies a Rate is high in relatives of probands b Relatives of bipolar probands tend to have unipolar depression Twin studies a Concordance rates are high in identical twins b Heritability rates higher for females Neurobiolooical ln uences Neurotransmitter systems Mood disorders are related to low levels of 5HT Balance of neurotransmitters Endocrine System quotStress hypothesisquot overactive HPA axiscortisol suppressed hippocampal neurogenesis
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