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Course 3.4 Affective Disorders all lectures!
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This is a summary of all the lectures for course 3.4: affective disorders given by Freddy van der Veen.
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Lecture 1 - Introductory lecture Affective DisordersThis is the first course of the clinical bachelor specialisation. Courses to look back on are
1.5, 1.6 and 2.6, they might have overlap with this course.
In this lecture we will find some practical information about the course and some theory
about the assignments.
Questions about the course directly to veen@essb.eur.nl
The tutorial groups are larger due to circumstances but there will be breakout rooms so that
students can all discuss in smaller groups.
Learning goals of this course
- to gain knowledge of the symptomatology and DSM-V classification of bipolar
disorder, depression and related illnesses
- to gain knowledge of the etiology
- to gain knowledge of the somatic and psychological treatment (meds, CBT)
- to be able to critically read and summarize scientific articles
- to be able to relate the above to the psychopathology in children
Course assignments
1. Psychodiagnostics using questionnaires
SCL-90 (symptom checklist; measures somatic and psychic complaints related to
psychopathology by means of self report, 90 items on 8 scales, use norm-scores)
BDI (beck depression inventory; measures the most notable symptoms of
depression, 21 items on 3 categories)
COPE (coping questionnaire; measures various types of coping)
→ using questionnaires for a specific case, to find out what’s going on and what we
can do with this. For a definitive diagnosis you need more than a couple of
questionnaires. You get a raw score and use norm tables to determine the qualitative
score.
2. Treatment plan
A treatment plan is always needed, independent, voluntary or forced hospitalization.
The treatment plan should prove information about the patient but also about how to
treat the patient. Be specific, don’t give general information about the disorder, but
connect it to the specific case.
What you need to know about the patient: who is it, patient history, medical history,
life history (the biography), social aspects (like work, money, relationships), somatic
aspects (the bodily aspects). Do you have sufficient information for a proper
diagnosis? Can you come up with a preliminary diagnosis? Maybe use interviews,
questionnaires of cognitive tasks to clarify everything better and be able to make a
final diagnosis. Think of treatment possibilities. Make a specific treatment plan, think
about social interventions, medication, psychological interventions like CBT etc.
Make a smart application of the guidelines for treatment.
What should be in the treatment plan:
- personal + clinical information
- anamnesis/course until hospitalization
- preliminary diagnosis (DSM-V)
, - goal of the patient
- the clinical goal
- the treatment plan → diagnostics + treatment
- medication
- expected time for treatment
- when should we evaluate?
3. Hamilton rating scale
This is the golden standard for assessing depressive symptoms (clinical trials). This
has to be applied to a fellow student, friend or family member. You also have to apply
another scale to this same person. It is important to reflect on the differences
between the Hamilton Rating Scale and the BDI. Think about when and how this
scale is applied and how cut-off scores can be interpreted. Can this be related to
diagnostic tools?
4. Checklist
Use a checklist to evaluate the scientific quality of various papers. For next week
we’ll be doing this on the Kaiser paper. For the final meeting you’ll have to select a
paper for yourself, one that you find interesting, and use the checklist and write a
short report on that based on the outcomes of the checklist, the last one will be in a
group of two or three.
The coordinator will judge whether you pass or fail. You can re-take every course
assignment. Can be completed in Dutch (the exam can’t). Deadlines are every friday.
The assignments are on the psychodiagnostics, make a diagnosis, focus on determining the
presence and severity of certain symptoms, which are often tested by using different types of
tests.
Lecture 2 - Major Depressive Disorder Affective disorders
This lecture will be seperated in two parts: first Freddy will talk about depression in general
and secondly he will present some of his own work in the field of depression.
Part one - general information about depression
Example: J.K. Rowling talking about depression. Freddy says depression is something we
mean when talking about having a bad mood or sad feelings. We should be aware of that,
clinical depression is a diagnosed mental illness. It is a state of mind that is different from
normal, this being you’re not able to function as you normally would.
DSM-V depressive disorders
- disruptive mood dysregulation disorder
- Major depressive disorder (one that you’ll have to know for the exam)
- Persistent Depressive Disorder (Dysthymia) (one that you’ll have to know for
the exam): this form of depression has milder symptoms, but they last long.
- Premenstrual Dysphoric Disorder
- Substance/Medication Induced Depressive Disorder
- Depressive Disorder Due to Another Medical Condition
- Other Specified Depressive Disorder
- Unspecified Depressive Disorder
, DSM-V symptoms MDD
One of the two core symptoms:
- depressed mood
- markedly diminished interest of pleasure (anhedonia)
At least 5 of the following symptoms:
- weight changes
- insomnia of hypersomnia
- psychomotor agitation or retardation
- loss of energy
- feelings of worthlessness
- diminished ability to think or concentrate
- recurrent thoughts of death, suicide, suicide attempts
MDD: at least 5 symptoms and 2 weeks.
Persistent Depressive Disorder: at least 3 symptoms and 2 years durability.
Next to this these types of depression there are some additional problems that can be
present next to the main diagnosis:
- anxiety
- mixed features
- melancholic features
- atypical features
- psychotic features
- catatonia
- postpartum onset
- seasonal pattern
Depression with Melancholic Features: There is a clear inability to experience any
pleasure, a depressed mood that is regularly worse in the morning, early waking, clear signs
of agitation, significant weight loss or signs of anorexia and excessive or inappropriate guilt.
Depression with Atypical Features: This is a type of depression where you see some
strange features that are not seen in other types of depression, such as the ability to
experience positive reactions to positive events, which is normally not seen often with
depressed individuals, weight gain or increased appetite, prolonged duration of sleep (10+
hours), sensation of heaviness in the limbs, over-sensitivity to interpersonal rejection.
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