Affective disorders
Colleges & literatuur
, College 1: Major Depressive Disorder
6-1-2025
Major depressive disorder
DSM-5 criteria for MDD:
A. Five or more symptoms have been present on nearly every day during the
same 2-week period and represent a change from previous functioning. At
least one of the symptoms must be (1) depressed mood or (2) loss of
interest. Others are:
3. weight loss without dieting or weight gain
4. insomnia and hyposomnia
5. psychomotor agitation or retardation observable by others
6. fatigue or loss of energy
7. feelings of worthlessness or excessive guilt
8. diminished ability to think or concentrate
9. recurrent thoughts about death, recurrent suicidal ideation without a
specific plan, or a suicide attempt or a specific plan for committing
suicide.
B. the symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
C. the episode is not attributable to the physiological effects of a substance or
another medical condition.
D. the occurrence of the episode is not better explained by another
psychiatric disorder.
Differentiations within symptom #9: recurrent thoughts about death, recurrent
suicidal ideation without a specific plan, or a suicide attempt or a specific plan for
committing suicide.
o Recurrent thoughts of death or suicidal ideation without a specific plan
Passive suicidal ideation: the thoughts involve a general desire to not exist
or to escape from life’s difficulties without any specific plans or intentions
to act on those thoughts.
o A specific plan for committing suicide Active suicidal ideation: these
thoughts involve specific contemplation or planning about committing
suicide. This might include thinking about methods, timing, or envisioning
the act itself. In this case you need to enact a crisis plan.
Persistent depressive disorder
DSM-5 criteria for dysthymia (persistent depressive disorder):
A. Depressed mood for most of the day for at least two years.
B. Presence, while depressed, of two or more of the following:
a. Poor appetite or overeating
b. Insomnia or hypersomnia
c. Low energy or fatigue
d. Low self-esteem
e. Poor concentration or difficulty making decisions
, f. Feelings of hopelessness
C. During the two-year period the individual has never been without the
symptoms in criteria A and B for more than 2 months at a time.
D. Criteria for a MDD may be continuously present for 2 years.
E. There has never been a manic or hypomanic episode.
F. The disturbance is not better explained by a persistent schizoaffective
disorder.
G. The symptoms are not attributable to the physiological effects of a
substance.
H. the symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
Key differences between MDD and dysthymia:
MDD Dysthymia
Duration of symptoms for at least two Symptoms lasting for two years
weeks
More severe form, stronger impact on Chronic but milder form, less impact
person’s life on person’s life.
Distinct periods without symptoms Can fluctuate in intensity but are
consistently present
May experience recurrent episodes
throughout life
Contemporary integrative interpersonal theory
Interpersonal theory states that humans are social creatures we constantly
have interpersonal dynamics. Interpersonal theory is grounded in personality
theory. Many forms of psychopathology are associated with interpersonal
impairment, not just depression. Interpersonal factors are also associated with
therapeutic alliance and therapeutic outcome.
Assumptions of interpersonal theory:
o the most important expressions of personality occurs in interpersonal
situations.
o Interpersonal functioning can by organized on two dimensions; agency and
communion. See figure 1.
figure 1
, o The interpersonal circumplex model (figure 1) organizes interpersonal
functioning across levels of experience.
o Satisfying agentic and communal motives drives the interpersonal
behaviour.
Interpersonal theory and depression
Stressful interpersonal situation increase hostile attributions, perception and
interpretation bias contribute to suspiciousness of others lead to defensive
and hostile or withdrawn interpersonal behaviours these behaviours are
usually perceived as unpleasant by others social repellent weakening the
individual’s supporting network rejections and confrontations promote
isolation, self-criticism and worthlessness direct symptoms of depression
Interpersonal theory is NOT a specific depression theory, though it can be used to
explain the development of psychopathology.
Motives what types of stands do I want to have in society and groups?
Traits personality traits
Behaviour motives and traits drive my behaviour.
In the context of depression maintenance, repeatedly experiencing negative
interpersonal situations and interpersonal rejection from others van for some
serve as self-verifying information (regarding cognitions of low self-worth) the
interpersonal cycle continues as the chance for stressful and negative
interpersonal situations further increase.
It is the interplay of interpersonal behaviours, perceptions, and affect not only
internally within a person’s mind but also between interaction partners that can
fuel interpersonal problems and internalising problems (including depression).
Importantly, these processes are thought to be long-lasting, indicating potential
long-term interpersonal problems and depression symptoms.
CIIT includes the social network of the person more than Beck’s cognitive theory
(internal processes only).
A main limitation of the CIIT is that it is based on personality, so doesn’t it work
better for people with personality pathology?
Colleges & literatuur
, College 1: Major Depressive Disorder
6-1-2025
Major depressive disorder
DSM-5 criteria for MDD:
A. Five or more symptoms have been present on nearly every day during the
same 2-week period and represent a change from previous functioning. At
least one of the symptoms must be (1) depressed mood or (2) loss of
interest. Others are:
3. weight loss without dieting or weight gain
4. insomnia and hyposomnia
5. psychomotor agitation or retardation observable by others
6. fatigue or loss of energy
7. feelings of worthlessness or excessive guilt
8. diminished ability to think or concentrate
9. recurrent thoughts about death, recurrent suicidal ideation without a
specific plan, or a suicide attempt or a specific plan for committing
suicide.
B. the symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
C. the episode is not attributable to the physiological effects of a substance or
another medical condition.
D. the occurrence of the episode is not better explained by another
psychiatric disorder.
Differentiations within symptom #9: recurrent thoughts about death, recurrent
suicidal ideation without a specific plan, or a suicide attempt or a specific plan for
committing suicide.
o Recurrent thoughts of death or suicidal ideation without a specific plan
Passive suicidal ideation: the thoughts involve a general desire to not exist
or to escape from life’s difficulties without any specific plans or intentions
to act on those thoughts.
o A specific plan for committing suicide Active suicidal ideation: these
thoughts involve specific contemplation or planning about committing
suicide. This might include thinking about methods, timing, or envisioning
the act itself. In this case you need to enact a crisis plan.
Persistent depressive disorder
DSM-5 criteria for dysthymia (persistent depressive disorder):
A. Depressed mood for most of the day for at least two years.
B. Presence, while depressed, of two or more of the following:
a. Poor appetite or overeating
b. Insomnia or hypersomnia
c. Low energy or fatigue
d. Low self-esteem
e. Poor concentration or difficulty making decisions
, f. Feelings of hopelessness
C. During the two-year period the individual has never been without the
symptoms in criteria A and B for more than 2 months at a time.
D. Criteria for a MDD may be continuously present for 2 years.
E. There has never been a manic or hypomanic episode.
F. The disturbance is not better explained by a persistent schizoaffective
disorder.
G. The symptoms are not attributable to the physiological effects of a
substance.
H. the symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
Key differences between MDD and dysthymia:
MDD Dysthymia
Duration of symptoms for at least two Symptoms lasting for two years
weeks
More severe form, stronger impact on Chronic but milder form, less impact
person’s life on person’s life.
Distinct periods without symptoms Can fluctuate in intensity but are
consistently present
May experience recurrent episodes
throughout life
Contemporary integrative interpersonal theory
Interpersonal theory states that humans are social creatures we constantly
have interpersonal dynamics. Interpersonal theory is grounded in personality
theory. Many forms of psychopathology are associated with interpersonal
impairment, not just depression. Interpersonal factors are also associated with
therapeutic alliance and therapeutic outcome.
Assumptions of interpersonal theory:
o the most important expressions of personality occurs in interpersonal
situations.
o Interpersonal functioning can by organized on two dimensions; agency and
communion. See figure 1.
figure 1
, o The interpersonal circumplex model (figure 1) organizes interpersonal
functioning across levels of experience.
o Satisfying agentic and communal motives drives the interpersonal
behaviour.
Interpersonal theory and depression
Stressful interpersonal situation increase hostile attributions, perception and
interpretation bias contribute to suspiciousness of others lead to defensive
and hostile or withdrawn interpersonal behaviours these behaviours are
usually perceived as unpleasant by others social repellent weakening the
individual’s supporting network rejections and confrontations promote
isolation, self-criticism and worthlessness direct symptoms of depression
Interpersonal theory is NOT a specific depression theory, though it can be used to
explain the development of psychopathology.
Motives what types of stands do I want to have in society and groups?
Traits personality traits
Behaviour motives and traits drive my behaviour.
In the context of depression maintenance, repeatedly experiencing negative
interpersonal situations and interpersonal rejection from others van for some
serve as self-verifying information (regarding cognitions of low self-worth) the
interpersonal cycle continues as the chance for stressful and negative
interpersonal situations further increase.
It is the interplay of interpersonal behaviours, perceptions, and affect not only
internally within a person’s mind but also between interaction partners that can
fuel interpersonal problems and internalising problems (including depression).
Importantly, these processes are thought to be long-lasting, indicating potential
long-term interpersonal problems and depression symptoms.
CIIT includes the social network of the person more than Beck’s cognitive theory
(internal processes only).
A main limitation of the CIIT is that it is based on personality, so doesn’t it work
better for people with personality pathology?