PSYC 435 Abnormal Psychology
Chapter 2 An Integrative Approach
Summarized Notes for Exam
Athabasca University.
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Chapter 4 and 5 summary
DSM 5 Mood Disorders (chapter 7)
Depressive Disorders
➢ major depressive disorder
➢ persistent depressive disorder (dysthymia)
➢ premenstrual dysphoric disorder
➢ disruptive mood dysregulation disorder
o kids were getting all these diagnoses of bipolar, even though they didn’t have all the other
traditional symptoms of mania. So they created another category that isn’t depression, really
would be called bipolar because of irritability … but isn’t bipolar
o they changed the name of dysthymia … dysthymia used to be a low-grade mood disorder for
when you didn’t meet the criteria for a major depressive disorder
Bipolar and Related Disorders
➢ bipolar I disorder
o to get diagnosed, you have to have 1 manic episode
o it has to be a full manic episode – the symptoms have to persist for at least a week. Elevated
mood, grandiosity, impulsivity, impression speech, those types of things
o cannot be better accounted for by another condition (like cocaine intoxication)
o actual mania… you just need 1 manic episode. Your symptoms only need to persist a week
➢ bipolar II disorder
o typically diagnosed by a hypomanic disorder
o hypomania
o doesn’t meet the full criteria – hypomanic episode combined with a major depressive episode
(alternating)
o when manic symptoms and major depressive symptoms co-occur… that’s called a mixed
episode, but that’s not necessarily a bipolar disorder
➢ cyclothymic disorder
Video of somebody with severe depressive disorder
➢ very depressed woman
➢ thought she was the devil
➢ she never made eye contact
➢ was treated with ECT
➢ what kind of symptoms would she have met criteria for to say she had a depressive disorder?
o Thoughts of wanting to die
o Anhedonia
o Speech was slow psychomotor retardation
o You can have psychotic symptoms with the mood disorder
o She may have a major depressive disorder with psychotic features
o For this particular specifier, you want to indicate whether they are mood congruent, or mood
incongruent
▪ She clearly has delusions. To get that specifier, you might also have delusions
▪ Would you say that her delusions are mood congruent or mood incongruent? Mood
congruent. Because she basically feels terrible, she feels awful to the point where she
feels like she is the devil
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▪ Incongruent would be like a hugely flat affect but also grandiose feelings, that would
be incongruent
▪ She also has inappropriate guilt. That’s not reasonable to feel guilty about.
▪ Pretty clear presentation of depressive episode
Major Depressive Disorder
Major depressive episode (MDE)
➢ extremely low mood or anhedonia (very sad, or feeling absolutely nothing) must be present at least
two weeks, plus others, such as:
o cognitive symptoms
▪ worthlessness, indecisiveness, suicidality, or thoughts of death
o vegetative or somatic symptoms
▪ weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation,
fatigue
o you need 5 symptoms, and they have to be either low mood or anhedonia, and then the other
4 would be either cognitive or somatic symptoms
o you need to have symptoms for 2 weeks
major depressive disorder (MDD)
➢ requires at least one MDE
o a single MDE is very unusual
o recurrent MDEs are more common
o once you’ve had one, you’re way more likely to have another
▪ is there full inter-episodic recovery? Is it partial remission or full remission between
episodes?
Persistent Depressive Disorder
➢ aka dysthymia = persistently depressed mood that continues for at least two years
o specify if MDE present, or if pure dysthymia
o can persist unchanged over long periods
o e.g., 20 years or more
➢ facts and statistics
o late onset = early 20s
o early onset = before age 20
▪ greater chronicity
▪ poorer prognosis
“major depressive disorder in partial remission”
- you start off with MDE and it starts to get better but never really goes away
- that’s a different problem than starting with dysthymia and then falling into MDE. This second situation
is what we would call double-depression
o DYSTHYMIA FIRST, MDE SECOND = double depression
Double Depression
Double depression = MDEs plus dysthymia
Dysthymic disorder often develops first
Facts and statistics
Double depression is common
Associated with more severe psychopathology
Associated with a problematic future course
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