Paradigms in Psychopathology and Mood Disorder

• Psychopathology


  Disabling disturbances in emotions
• Mood disorders


  • Depressive disorders
  • Bipolar disorders
• Depressive disorders


  • Involve extreme sadness and disengagement
  • Involve extreme elation and irritability
• Major Depressive Disorder (MDD)


  Episodic disorder, present for a period and then clear
• 2/3 of people with MDD experience at least one more episode
• Dysthymia


  Chronic depressive disorder, chronically depressed for more than half of the time and at least two additional symptoms
• Mean duration of dysthymia is more than five years
• Depressive disorder diagnoses (DSM-V)

  • Major Depressive Disorder, single episode
  • Major Depressive Disorder, recurrent
  • Major Depressive Disorder, chronic subtype
  • Dysthymia
• Epidemiology of depressive disorders


  • Life-time prevalence of MDD is around 16%
  • Life-time prevalence of dysthymia is around 2.5%
  • Onset is mostly in late teens to early twenties
  • After age 15 MDD is twice as common in women, no gender differences in childhood
  • Prevalence has increased across the 20th century
• Prevalence of depressive disorders varies across different cultures
• Prevalence of depressive disorders is three times higher when living in poverty
• Bipolar disorders


  Defined by manic symptoms, but differ in severity and duration
• Mania


  A state of intense elation or irritability, with symptoms like louder speech, flights of ideas, excessive self-confidence, and reduced need for sleep
• Hypomania


  Less distinct manic symptoms, lasting at least 4 days, but no impairment in functioning
• Bipolar I Disorder


  Diagnosis requires at least one manic episode in a lifetime
• Bipolar I Disorder has high rates of recurrence, with more than 50% experiencing four or more episodes
• Bipolar II Disorder


  Requires at least one major depressive episode and at least one episode of hypomania
• Cyclothymic disorder


  A chronic disorder with frequent but mild symptoms of depression alternating with mild symptoms of mania
• Epidemiology of bipolar disorders


  • Life-time prevalence of bipolar I disorder is around 1%
  • Life-time prevalence of bipolar II disorder is around 0.3%
• Bipolar I Disorder


  High rates of recurrence, more severe form of mental illness than Major Depressive Disorder (MDD)
• Bipolar II Disorder


  At least one major depressive episode and at least one episode of hypomania, a milder form of bipolar disorder
• Cyclothymic disorder


  A chronic disorder with frequent but mild symptoms of depression, alternating with mild symptoms of mania
• Bipolar disorder types


  • Bipolar I
  • Bipolar II
  • Cyclothymic
• Life-time Prevalence: Bipolar I disorder ≈ 1%, Bipolar II disorder ≈ 0.4-2%, Cyclothymia ≈ 4%
• Onset of bipolar disorders in more than 50% before age 25
• Gender


  Equally often in women & men, but women experience more depressive episodes
• 2/3 of people with bipolar disorders also suffer from anxiety disorders, 1/3 also suffer from substance abuse
• Overview of the lecture: Current paradigms in psychopathology, Mood disorders (MDD and Bipolar Disorder)
• Next lecture: Aetiology, Treatment approaches for MDD
• The Wealth of Nations was written


  1776
• Rational


  (in classical economic theory) economic agents are able to consider the outcome of their choices and recognise the net benefits of each one
• Consumers act rationally by


  Maximising their utility
• Producers act rationally by


  Selling goods/services in a way that maximises their profits
• Workers act rationally by


  Balancing welfare at work with consideration of both pay and benefits
• Governments act rationally by


  Placing the interests of the people they serve first in order to maximise their welfare
• Rationality in classical economic theory is a flawed assumption as people usually don't act rationally
• Marginal utility


  The additional utility (satisfaction) gained from the consumption of an additional product
• If you add up marginal utility for each unit you get total utility