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Features and Epidemiology Causes and Prevention Assessment and Treatment
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Emotions Cognitions Behaviors Cycle of Major D...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Emotions Cognitions Behaviors Cycle of Major D...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Emotions Cognitions Behaviors Cycle of Major D...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Emotions Cognitions Behaviors Cycle of Major D...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Emotions Cognitions Behaviors Cycle of Major D...
<ul><li>Click below to see a one-minute video </li></ul><ul><li>depressive episode </li></ul>Features and  Epidemiology Ca...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Manic Normal Depressive Cycle of Major Depress...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment <ul><li>Symptoms of a Manic Episode </li></ul>...
Mania in video <ul><li>Click below for two one-minute videos: </li></ul><ul><ul><li>mania-grandiosity </li></ul></ul><ul><...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Manic Normal Depressive
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Manic Normal Depressive
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Manic Normal Depressive
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Will  to live Feeling  thoughts  of death Suic...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Note: These numbers reflect the fact that some...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment 0 5 10 15 20 25 Prevalence 5-14 15-24 25-44 45...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Amygdala Anterior  cingulate cortex Prefrontal...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Features and  Epidemiology Assessment  and Tre...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Features and  Epidemiology Assessment  and Tre...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Features and  Epidemiology Assessment  and Tre...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Features and  Epidemiology Assessment  and Tre...
<ul><li>Medication: </li></ul><ul><ul><li>Selective serotonin reuptake inhibitors (SSRIs) </li></ul></ul><ul><ul><li>Tricy...
Features and  Epidemiology Causes and  Prevention Assessment  and Treatment Features and  Epidemiology Assessment  and Tre...
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Ch7moodandsuic

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Mood disorders and suicide lecture

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  1. 1. Features and Epidemiology Causes and Prevention Assessment and Treatment
  2. 2. Features and Epidemiology Causes and Prevention Assessment and Treatment
  3. 3. Features and Epidemiology Causes and Prevention Assessment and Treatment Emotions Cognitions Behaviors Cycle of Major Depressive Disorder Normal Good mood. Thoughts about what one has to do that day. Thoughts about how to plan and organize the day. Rising from bed, getting ready for the day, and going to school or work.
  4. 4. Features and Epidemiology Causes and Prevention Assessment and Treatment Emotions Cognitions Behaviors Cycle of Major Depressive Disorder Feeling upset and sad, perhaps becoming a bit teary-eyed. Dwelling on the negative aspects of the day, such as a couple of mistakes on a test or a cold shoulder from a coworker. Coming home to slump into bed without eating dinner. Tossing and turning in bed, unable to sleep. Some difficulty concentrating. Normal Mild
  5. 5. Features and Epidemiology Causes and Prevention Assessment and Treatment Emotions Cognitions Behaviors Cycle of Major Depressive Disorder Mild discomfort about the day, feeling a bit irritable or down. Thoughts about the difficult of the day. Concern that something will go wrong. Taking a little longer than usual to rise from bed. Slightly less concentration at school or work. Normal Mild Moderate
  6. 6. Features and Epidemiology Causes and Prevention Assessment and Treatment Emotions Cognitions Behaviors Cycle of Major Depressive Disorder Intense sadness and frequent crying. Daily feelings of “heaviness” and emptiness. Thoughts about one’s personal deficiencies, strong pessimism about the future, and thoughts about harming oneself (with little intent to do so). Inability to rise from bed many days, skipping classes at school, and withdrawing from contact with others. Normal Mild Moderate Depression – Less Severe
  7. 7. Features and Epidemiology Causes and Prevention Assessment and Treatment Emotions Cognitions Behaviors Cycle of Major Depressive Disorder Extreme sadness, very frequent crying, and feelings of emptiness and loss. Strong sense of hopelessness. Thoughts about suicide, funerals, and instructions to others in case of one’s death. Strong intent to harm oneself. Complete inability to interact with others or even leave the house. Great changes in appetite and weight. Suicide attempt or completion. Normal Mild Moderate Depression – Less Severe Depression – More Severe
  8. 8. <ul><li>Click below to see a one-minute video </li></ul><ul><li>depressive episode </li></ul>Features and Epidemiology Causes and Prevention Assessment and Treatment
  9. 9. Features and Epidemiology Causes and Prevention Assessment and Treatment Manic Normal Depressive Cycle of Major Depressive Disorder
  10. 10. Features and Epidemiology Causes and Prevention Assessment and Treatment <ul><li>Symptoms of a Manic Episode </li></ul><ul><ul><li>Inflated self-esteem or grandiosity </li></ul></ul><ul><ul><li>Decreased need for sleep, such as feeling rested after only 3 hours of sleep </li></ul></ul><ul><ul><li>More talkative than usual or pressure to keep talking </li></ul></ul><ul><ul><li>Subjective experience that one’s thoughts are racing, </li></ul></ul><ul><ul><li>or flight of ideas </li></ul></ul><ul><ul><li>Distractibility </li></ul></ul>
  11. 11. Mania in video <ul><li>Click below for two one-minute videos: </li></ul><ul><ul><li>mania-grandiosity </li></ul></ul><ul><ul><li>mania-inappropriate affect </li></ul></ul><ul><li>If you’re interested, a one-minute video of the same individual in the midst of a depressive episode: </li></ul><ul><ul><li>bipolar-depressive episode </li></ul></ul>
  12. 12. Features and Epidemiology Causes and Prevention Assessment and Treatment Manic Normal Depressive
  13. 13. Features and Epidemiology Causes and Prevention Assessment and Treatment Manic Normal Depressive
  14. 14. Features and Epidemiology Causes and Prevention Assessment and Treatment Manic Normal Depressive
  15. 15. Features and Epidemiology Causes and Prevention Assessment and Treatment Will to live Feeling thoughts of death Suicidal ideation Planning suicidal acts Suicide attempt Suicide completion
  16. 16. Features and Epidemiology Causes and Prevention Assessment and Treatment Note: These numbers reflect the fact that some people have more than one mood disorder. Disorder 0 Any mood disorder Major depressive disorder Dysthymia Bipolar I and II disorders 20.8 9.5 16.6 6.7 2.5 1.5 3.9 2.6 Lifetime prevalence rate (%) 12-month prevalence rate (%) 5 10 15 20 25 Percentage
  17. 17. Features and Epidemiology Causes and Prevention Assessment and Treatment 0 5 10 15 20 25 Prevalence 5-14 15-24 25-44 45-64 Male Female Age at death in years 30 35 1.2 0.3 17.1 3.0 31.1 4.0 21.3 6.2 65+ 21.3 5.4
  18. 18. Features and Epidemiology Causes and Prevention Assessment and Treatment Amygdala Anterior cingulate cortex Prefrontal cortex Caudate nucleus, putamen Basal gangalia Hippocampus Pons
  19. 19. Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment Biological vulnerabilities/early predispositions: Genetic contributions, neurochemical and hormonal changes, brain changes Early family problems: Poor attachment, disengaged parents, expressed emotion, modeling of parental depression Stressful life events: Family conflict, alienation from others, academic and other challenges Cognitive-stress and behavioral vulnerabilities: Sense of learned helplessness and hopelessness, intense negative emotions and arousal, escape-oriented behavior, lack of social support Possible mood disorder
  20. 20. Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment <ul><li>RAP-A teaches adolescents to: </li></ul><ul><ul><li>Declare existing strengths </li></ul></ul><ul><ul><li>Manage stress </li></ul></ul><ul><ul><li>Modify negative and irrational thoughts </li></ul></ul><ul><ul><li>Solve problems efficiently </li></ul></ul><ul><ul><li>Develop and use social support networks </li></ul></ul><ul><ul><li>Enhance social skill and recognize other perspectives </li></ul></ul>
  21. 21. Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment Hamilton Rating Scale for Depression
  22. 22. Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment Assess sociodemographic risk factors <ul><li>Elderly </li></ul><ul><li>Unmarried </li></ul><ul><li>White </li></ul><ul><li>Male </li></ul><ul><li>Living alone </li></ul>How are things going in your marriage, in your family, at home, at work?” (Cover health, financial, marital, family, legal, and occupational factors) <ul><li>“ Have you experienced sad, blue, or empty feelings and at least two of the following in the past two weeks?” </li></ul><ul><ul><li>Trouble falling or staying asleep </li></ul></ul><ul><ul><li>Feeling tired or having little energy </li></ul></ul><ul><ul><li>Poor appetite or overeating </li></ul></ul><ul><ul><li>Little interest or pleasure in doing things </li></ul></ul><ul><ul><li>Feeling bad about yourself </li></ul></ul><ul><ul><li>Trouble concentrating </li></ul></ul><ul><ul><li>Feeling fidgety, restless, or unable to sit still </li></ul></ul><ul><li>“ Have you felt nervous, anxious, or on edge?” </li></ul><ul><li>“ Have you had anxiety or panic attacks recently?” </li></ul>Ask about stressors Screen for depression and associated anxiety or agitation “ Have you ever felt you should cut down on your drinking?” “ Have people annoyed you by criticizing your drinking?” “ Have you ever felt bad or guilty about your drinking?” “ Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?” Yes to two or more means probable alcohol abuse. Screen for alcohol abuse <ul><li>“ Have you had thoughts about death, or about killing yourself?” If yes, ask: </li></ul><ul><ul><li>“ Do you have a plan for how you would do this?” </li></ul></ul><ul><ul><li>“ Are there means available (e.g., a gun and bullets or poison)?” </li></ul></ul><ul><ul><li>“ Have you actually rehearsed or practiced how you would kill yourself?” </li></ul></ul><ul><ul><li>“ Do you tend to be impulsive?” </li></ul></ul><ul><ul><li>“ How strong is your intent to do this?” </li></ul></ul><ul><ul><li>“ Can you resist the impulse to do this?” </li></ul></ul><ul><ul><li>“ Have you heard voices telling you to hurt or kill yourself?” </li></ul></ul><ul><li>Ask about previous attempts, especially the </li></ul><ul><li>degree of intent. </li></ul><ul><li>Ask about suicide of family members. </li></ul>Assess risk of suicide
  23. 23. <ul><li>Medication: </li></ul><ul><ul><li>Selective serotonin reuptake inhibitors (SSRIs) </li></ul></ul><ul><ul><li>Tricyclics </li></ul></ul><ul><ul><li>Mood stabilizers </li></ul></ul><ul><li>Electroconvulsive therapy </li></ul><ul><li>Transcranial magnetic stimulation </li></ul>Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment
  24. 24. Features and Epidemiology Causes and Prevention Assessment and Treatment Features and Epidemiology Assessment and Treatment

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