Clarke University Psychology Department PSYC 221 Abnormal Psychology Spring 2013 Assessment Three Learning Objectives Chapters 8,13 Mood Disorders Personality Disorders 3. Explain the features of major depression. c 1980 United Feature Syndicate, I Depression Audio Clip Clip Face of depression 2 Face of depression 3 Face of depression 4 Face of depression 5 Face of depression 6 Face of depression 7 Face of depression 8 Face of depression 9 Face of depression 10 Face of depression 11 Face of depression 12 Face of depression 13 Face of depression 14 Face of depression 15 Face of depression 16 Face of depression 17 Face of depression 18 Face of depression 19 Face of depression 20 Face of depression 21 Face of depression 22 Face of depression 23 Face of depression 24 Face of depression 25 Face of depression 26 Major Depressive Disorder At least five of the following symptoms have been present during the same two week period and represent a change from previous functioning. Major Depressive Disorder Depressed mood (or can be irritable mood in children and adolescents) most of the day, nearly every day, Depressed Mood How is your mood? Have you been feeling sad, down, or depressed? If Yes: For how long have you been feeling down or depressed? How bad is the feeling? c 1995 Wm... C. Brown PET Scans of “Normal” Persons c 1995 Wm... C. Brown PET Scans of a Rapid-Cycling Bipolar Person (24-48 hr. cycles) Major Depressive Disorder Markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day, Anhedonia/Loss of Pleasure Have you lost interest in the things that you used to enjoy doing? If Yes: What do you normally enjoy doing? What have you lost interest in? For how long have you not enjoyed these activities? Major Depressive Disorder Significant weight loss or weight gain when not dieting (e.g., more than 5% of body weight in a month), or decrease or increase in appetite nearly every day, Appetite Changes Have there been changes in your eating habits? If Yes: Have you gained or lost weight? How much weight? Over what time have you (gained or lost) the weight? Major Depressive Disorder Insomnia or hypersomnia nearly every day, Sleep Disturbance How have you been sleeping? If changed: Are you having trouble falling asleep, staying asleep, or waking up early and not falling back asleep. How long has this been going on? How many hours are you sleeping a night (or throughout the day)? Major Depressive Disorder Psychomotor agitation or retardation nearly every day, Agitation or Retardation Have you been restless or feeling so slowed down that you feel sort of like lead? If Yes: Are you pacing around or having trouble sitting still? Or Are you feeling so slowed down that you feel like your stuck in the mud or your shoes are extremely heavy? Depression Comic Cornered Depression Diagnosis Major Depressive Disorder Fatigue or loss of energy nearly every day, Energy Level How is your energy level? If changed: Are you getting your daily jobs accomplished? How tired and worn out have you been feeling? Is your house (apartment) a mess? Major Depressive Disorder Feelings of worthlessness or excessive or inappropriate guilt nearly every day, Worthlessness/Guilt Have you been really down on yourself or feeling bad about yourself or decisions? If Yes: Do you feel like someone should throw you away? Do you feel like a failure? What have you been feeling guilty about? Major Depressive Disorder Diminished ability to think or concentrate, or indecisiveness, nearly every day, Thinking Problems Have you had more trouble making decisions or concentrating on things? If Yes: What decisions are you having trouble making? Do you have trouble focusing on things that are important and you really want to be successful at? Major Depressive Disorder 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. Suicidal Thinking Have you been feeling so bad that you have been thinking about dying? If Yes: Do you wish that you would go to sleep and not wake up? If you were to die, how would you do it? Do you have the (pills, gun, rope, etc.) at your home? Why does this happen? Serotonin Pathways Serotonin Neurons Cell Body and Axons http://thedea.org/pictures/sero toninonthebrain.jpg c 1992 Harper Collins Publishers Synapse of a Neuron c 1995 Wm... C. Brown PET Scans of a Rapid-Cycling Bipolar Person (24-48 hr. cycles) Degrees of Major Depressive Episode Mild Moderate Severe without Psychotic Features Severe with Psychotic Features In Partial Remission In Full Remission c 1994 American Psychiatric Assoc... Major Depressive Disorder, Single Episode Presence of a single Major Depressive Episode. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition. If the full criteria are currently met for a Major Depressive Episode, specify its current clinical status and/or features: Mild, Moderate, Severe Without Psychotic Features/Severe With Psychotic Features Chronic With Catatonic Features With Melancholic Features With Atypical Features With Postpartum Onset Major Depressive Disorder, Single Episode If the full criteria are not currently met for a Major Depressive Episode, specify the current clinical status of the Major Depressive Disorder or features of the most recent episode: In Partial Remission, In Full Remission Chronic With Catatonic Features With Melancholic Features With Atypical Features With Postpartum Onset Recording Procedures The diagnostic codes for Major Depressive Disorder (single Episode and Recurrent) are selected as follows: The first three digits are 296. The fourth digit is either 2 (if there is only a single Major Depressive Episode) or 3 (if there are recurrent Major Depressive Episodes). If the full criteria are currently met for a Major Depressive Episode, the fifth digit indicates that current severity as follows: 1 for Mild severity, 2 for Moderate severity, 3 for Severe Without Psychotic Features, 4 for Severe With Psychotic Features. If the full criteria are not currently met for a Major Depressive Episode, the fifth digit indicates the current clinical status of the Major Depressive Disorder as follows: 5 for In Partial Remission, 6 for In Full Remission. If the severity of the current episode or the current remission status of the disorder is unspecified, then the fifth digit is 0. Other specifiers for Major Depressive Disorder cannot be coded. pe03513_