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depressive disorders: models and treatments

Outline. Types of DepressionDiagnostic CriteriaPrevalenceModels of DepressionTreatment. Types of Depression. AKA-

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depressive disorders: models and treatments

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    1. Depressive Disorders:Models and Treatments Erlanger A. Turner Psychopharmacology Texas A&M University

    3. Types of Depression AKA- “Mood/Affective Disorders” Unipolar Depression Bipolar disorder Dysthymia Cyclothymia Seasonal Affective Disorder

    4. Diagnostic Criteria Presence of a single major depressive episode (MDE). The MDE is not accounted for by schizoaffective disorder, schizophrenia, or psychotic disorder NOS. There has never been a manic episode, a mixed episode, or hypomanic episode. Note: see DSM-IV-TR for full criteria and specifiers

    5. Common Symptoms Mood of sadness, despair, emptiness Anhedonia Low self-esteem Low motivation and social withdrawl Pessimistic thinking Irritability Suicidal thoughts

    6. Prevalence At least 8 percent of adults in the United States experience serious depression at some point during their lives. 10-25 % women 5-12% men Appears to be unrelated to ethnicity, education, income, or marital status. women are two to three times more likely than men to suffer from depression

    7. Models of Depression Most psychologists believe depression results from an interaction between stressful life events and a person’s biological and psychological vulnerabilities.

    8. Models of Depression Theory of Learned Helplessness Role of Monoamines The Monoamine Hypothesis Cortisol & Depression Brain Abnormailities

    9. Theory of Learned Helplessness According to Seligman, people become depressed when they make an attribution that they have no control over the stress in their lives. Attributional styles include: Internal: personal failure Stable: things will always be their fault Global: extends across a variety of issues

    10. Role of Monoamines monoamine hypothesis of depression predicts that the underlying basis of depression is a depletion in the levels of serotonin, norepinephrine, and/or dopamine in the central nervous system. However, intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders. However, intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders.

    11. Cortisol and Depression Increased cortisol level have been associated with depressive symptoms perceived stress activates the central nervous system (CNS), causing the release of corticotropin releasing hormone (CRH) from the hypothalamus, adrenal corticotrophic hormone (ACTH) from the anterior pituitary, and cortisol from the adrenal cortex.

    12. Brain Abnormalities

    13. Treatments Depression can be treated effectively with antidepressant drugs, psychotherapy, or a combination of both. 70 percent of people with depression respond to antidepressant drugs medications appear to work by altering the levels of serotonin (5-HT), norepinephrine (NE), and other neurotransmitters in the brain.

    14. Psychological Treatments Cognitive Behavioral Therapy Interpersonal Therapy Alternative Interventions: CBASP (Cognitive Behavioral Analysis System of Psychotherapy)

    15. Pharmacological Treatments antidepressant drugs fall into three major classes: tricyclics monoamine oxidase inhibitors (MAOs) and selective serotonin reuptake inhibitors (SSRIs).* *probably most commonly used

    16. References Burkea,H., Davisb, M., Ottec, C., & Mohr, D.C. (2005). Depression and cortisol responses to psychological stress: A meta-analysis. Psychoneuroendocrinology, 30, 846–856 Carlson,N. (2004) Physiology of Behavior (8th edition) Pearson Publishing. pp 535-543. Diagnostic and Statistical Manual of Mental Disorder (1994). American Psychiatric Association. Preston, J., O’Neal, J., & Talaga, M. (2005). Handbook of Clinical Psychopharmacology for Therapist (4th edition). New Harbinger Publications. Microsoft Encarta <http://encarta.msn.com/encyclopedia_761578989_1/Depression_(psychology).html> National Institute of Mental Health http://www.nimh.nih.gov/publicat/depression.cfm Neuron cartoons <personal communication, Dr. Wellman>

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