Lecture 3: Depression and mood disorders - Exclusive

Lecture 3: Depression and mood disorders - Exclusive

This is the summary of the Lecture 3: Depression and mood disorders. In this lecture, the following chapters were discussed: Chapter 7 Davey (2021)

 

Lecture 3

Depression and mood disorders

“Though I am often in the depths of misery, there is still calmness, pure harmony and music inside me” Vincent van Gogh

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This content refers to .....
Lectures Mental Health Module

Lectures Mental Health Module

In this bundle, I include the summaries of lectures that I participated for the module Mental Health in the year 2023-2024. The bundle includes the following lectures:

- Lecture

........Read more
Lecture 1: Introduction Psychopathology & Psychodiagnostics - Exclusive

Lecture 1: Introduction Psychopathology & Psychodiagnostics - Exclusive

This is the summary of the Lecture 1: Introduction Psychopathology & Psychodiagnostics. In this lecture, the following chapters were discussed: Chapter 1 Davey (2021) and Chapter 1 to 4 of Luteijn & Barelds (2019)

 

Lecture 1

Psychopathology & Psychodiagnostics

Psychodiagnostics

  • By collecting information about client and their environment:
  • The goal is to design the best approach to problems and interests of the client
  • And to evaluate our approach (during and after the treatment)

Characteristics of clinical diagnosis:

  • Theory development of problematic behaviour
  • Operationalisation and its subsequent measurements
  • Application of relevant diagnostic methods

The diagnostic process:

1. Application

  • 1. Analysis of the request
    • Information about the referrer
    • Type and content of request
    • Referrer’s knowledge about client
  • 2. Analysis of request for help

2. The diagnostic reflection

  • Studying file data
  • Weigh information
  • Take into account own bias, knowledge, preferences
  • When needed: literature search, and refer to a colleague

3. Diagnostic scenario

  • Collect all questions
  • Formulate preliminary theory about client
  • Relate problems to questions --> there are 5 basic questions from which all questions can be summarized
    • 1. Recognition --> What?
      • E.g. To what extent does Greg suffer from feelings of
        disconnection?
    • 2. Explanation --> Why?
      • E.g. To what extent can Greg's exposure to a traumatic event in
        the past explain his flashbacks?
    • 3. Prediction --> What will happen in the future?
      • E.g. To what extent will the symptoms get better in the future?
    • 4. Indication --> How can problems be solved?
      • E.g. Can exposure therapy reduce the symptoms?
    • 5. Evaluation --> Did it work?
      • E.g. To what extent has exposure therapy reduced the
        symptoms?

4. Diagnostic research

  • Select research tools considering:
    • Questions that need to be answered
    • The tools are suited to measure what you aim to measure --> come up with testable predictions, to make sure you don’t fall into confirmation bias
    • Efficiency

5. Reporting

  • First aim: summarise diagnostic process, answering the 5 questions
  • Second aim: effective communication about client
  • Diagnostic quality
    • Psychodiagnostics defined as:
      • Diagnostic frames of reference or theories
        • Individual
        • Development --> Freud theories
        • Context --> If context influences client’s problematic behaviour
      • The three frames of references can be tested in test theory models and statistical methods
.....read more
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Lecture 2: Classifying Mental Health - Exclusive

Lecture 2: Classifying Mental Health - Exclusive

This is the summary of the Lecture 2: Classifying Mental Health. In this lecture, the following chapters were discussed: Chapter 2.1 Davey (2021)

 

Lecture 2

Classification systems

Why do we classify? It’s a common language

  • Disorder: the condition the person is experiencing
  • Diagnosis: Conceptualization of this disorder

We classify to:

  • Evaluate person faster
  • Be able to group disorders and accumulate info about them
  • Quickly make decision on appropriate treatment.

Classification efforts:

Diagnostic and Statistical Manual for Psychiatric Disorders(DSM)

  • For psychiatric disorders. It is the main one used globally. The main focus is to classify mental disorders
    • Emerged 1917 for psychotic disorders, thus it only contained disorders that needed treatment
    • DSM that was published 1952 --> dysfunctional behaviours: gave a terminology for behaviours outside of the norm, but did not explain how to diagnose
    • DSM III developed criteria to diagnose. They used an axes system of 5 different dimensions to describe clients
    • DSM-5 combined axes system, and list of scales

International Statistical Classification of Diseases and Related Health Problems (ICD)

  • First formal classification system for mental disorders
  • Main focus is not to diagnose, but to help countries reduce burden of disease
  • Diagnostic criteria similar to DSM

Psychodynamic Diagnostic Manual (PDM)

  • Understanding of the client as a whole
  • Life-long approach: diagnosis dependent on developmental stages
  • Not as evidenced

Level of Personality Organization:

  • 1st thing assessed is the level of personality organisation --> how the person has come together
    • Identity: do they have stable identity?
    • Object relations: do they have stable relationships?
    • Level of defences: coping mechanisms differ in their benefits and maturity
      • Psychotic level: delusional projection, psychotic denial, psychotic distortion
      • Borderline level: splitting, projective identification, idealization/devaluation, denial, acting out
      • Neurotic level: repression, reaction formation, intellectualization, displacement, undoing
      • Healthy level: anticipation, self-assertion, sublimation, suppression, altruism, and humour
    • Reality testing: ability to appreciate conventional notions of what is realistic

P-Axis: Personality Syndromes

  • A list of labels to differentiate mental disorders --> influence on treatment choice
    • It discusses phenomenon as opposites: depending on defences, you’ll have one or the other label, and they’ll be opposite
  • Sometimes client’s experience is similar as the description from DSM, but other times is not the case. Then, a psychoanalysis approach can help to understand their experience better. For instance, when someone is escaping as a defence mechanisms, and this produces symptoms of mental health disorder, then psychoanalysis can be useful.

M-Axis: profile of mental functioning

  • Classify client in terms
.....read more
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Lecture 3: Depression and mood disorders - Exclusive

Lecture 3: Depression and mood disorders - Exclusive

This is the summary of the Lecture 3: Depression and mood disorders. In this lecture, the following chapters were discussed: Chapter 7 Davey (2021)

 

Lecture 3

Depression and mood disorders

“Though I am often in the depths of misery, there is still calmness, pure harmony and music inside me” Vincent van Gogh

What is a mood disorder?

“A mood disorder is not just a diagnosis”

  • Mental health disorder affects person’s emotional state
  • Symptoms that last relative long periods
  • Long-term deficits in social, functional, cognitive areas

Diagnostics:

  • Two groups of mood disorders, with many subtypes
    • 1. Depressive disorders
    • 2. Bipolar disorders
  • Diagnostics:
    • Language that professionals speak. Helps communication, comparison, prediction, and treatment planning
    • It does not give meaning to patience experience
    • It does not give causal explanations

Etiology of mood disorders

  • Diathesis-stress models: stressful experiences trigger disorders in people who are vulnerable
  • Depression: (potential) genetic predisposition + psychological stressors
  • Bipolar: a more pronounced genetic component

Risk factors:

Depression:

  • Social and environmental factors
  • Gender
  • Neurobiological factors
  • Stressful life events
  • Long-term health issues
  • Ethnic minority? Not always, when it comes to global results
  • Negative emotionality (e.g. rumination, neuroticism)

Bipolar:

  • Genetics
  • Drug/alcohol use
  • Stressful life events
  • Neurobiological factors (e.g. neurotransmitters)
  • Cognitive deficits (related to difficulties in
    emotion regulation)

The diagnostic process:

  • Interview, observe, and use of instruments
    • History, level of functioning (how well client functions in daily life --> e.g. functioning depression, nonfunctioning depression)
  • Clinical interview protocols (semi-structured, disorder-based)
  • Questionnaires for screening --> not in-depth analysis, general classification of client’s symptoms
  • Special challenges:
      • Interviewing depressed patients: time-consuming, due to their slow/passivity attitude
      • In (hypo) mania: they don’t want to talk to you, they feel great. There is no experienced problem.

Treatments of mood disorders:

  • Talk therapies
  • Medication
  • Other treatments:
    • Electroconvulsive therapy (ECT): was one of the most invasive treatments, but it has adapted. Now it seems to be really effective for severe persistent depression (when nothing else worked)
    • Transcranial magnetic stimulation (TMS): pulses of magnetic energy to increase brain activity at a specific location
    • Light therapy: supplementing natural sunlight with artificial light to treat SAD

Prognosis of mood disorders:

  • Recurring or ongoing symptoms --> dependent on:
    • The severity of the condition
    • How early is it’s diagnoses (and whether something has been done for treatment)
    • Whether it was treated properly
    • Comorbidity
.....read more
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