COMPLETE & CONCISE Summary of All Literature - 3.4 Affective Disorders 2024
20 vues 2 fois vendu
Cours
3.4 Affective Disorders (FSWP3082K)
Établissement
Erasmus Universiteit Rotterdam (EUR)
Complete summary of ALL LITERATURE. Concise and summarised into easy to understand and shortened terms. Year 2023/2024 updated summary, completed the course with grade 8.3!
Hermann et al (2022) → Time for United Action on Depression: a
Lancet-World Psychiatric Association Commission
● Large review about how depression should be treated (risks, symptoms, care,
recommendations for the future)
● What is depression?
○ Controversies surrounding diagnostic criteria → continuous or categorical &
levels of severity (threshold issue)
○ Higher orders dimensions (underlying phenomena)
○ Specific types of depression → melancholic, psychotic, atypical, etc
○ Age → in older people underdiagnosed
○ Gender → more common in women
○ Culture → higher prevalence of somatic symptoms in non-western cultures
■ Higher association with suicidality in high income countries
○ Different from grief
● Epidemiology & burden
○ 4.7% has an episode in 12 months
○ 33-50% with depression have an episode in 12 month period
○ Persistent depression = 12% of all depression
○ Median age of onset = 26
○ Secondary peak of onset later in life
○ Subthreshold symptoms depression prevalence → 17%
■ Higher prevalence in children & adolescents
○ Comorbidities → anxiety, substance abuse & physical disorders (can be cause as
well as consequence of diseases)
○ Depression is most common disorder in suicide deaths
■ Most deaths occur during first episode
○ Impact on functioning → severe health condition, high disability (especially later
in life)
■ Effects on education, employment, economic, relationships, parent,
caregiving roles
● Causes & risk factors
○ Familial risk (often together with bipolar, substance abuse, anxiety)
○ Risk factors → genetic common variants, other psychopathology, early childhood
adversity, interpersonal styles & personality disorders, lifestyle, women, poverty
○ Protecting factors → secure attachment, cognitive abilities, self regulation,
community support
○ Precipitating factors → stressful life events, proximal environmental influences,
childhood sensitization (role in vulnerability)
, ○ Perpetuating factors → stress generation, substance abuse, behavior patterns,
cognitive biases, ruminative response style
○ Models of mechanisms
■ Probabilistic chain → conditioned by timing, dosage, context
■ Diathesis stress model → common theories (vulnerability to stressor)
■ Transactional model → vulnerabilities can change over time
■ Gene environment correlation → individual more likely to be exposed to
environment depending on gene (linked to diathesis stress)
■ Gut microbiome → complex interaction (linked to GABA & serotonin)
■ Environmental factors can be far removed from depression (time wise)
○ Neural pathways → many genetic variants (each low effect), frontal
hypometabolism & hippocampal atrophy, limbic & subcortical abnormalities
■ Not caused by just 1 gene → contemporary interconnected view
■ Mediators could be life stressors
● Public understanding
○ Negative attitudes → associated with negative outcomes
○ Higher stigma → men, unemployed, high cohesion affection communication
families
○ Less negative attitudes when attributed to spiritual problems, young people
○ Depression literacy → knowledge about strategies to maintain mental health
○ Acceptance is growing
○ Raising awareness → biomedical approaches unsuccessful, social contact
interventions greater benefit
● Interventions to reduce burden
○ Decrease stigma, improve literacy, advocacy, social contact
○ School based programs for younger people (bc of early onset)
○ Treatment preferences → psychotherapy > antidepressants (neg attitudes)
■ There is stigmatization in medical community
○ Prevention → prevention science & population health science
○ Universal, selective or indicated interventions
○ Proximal interventions → small effects
■ Costly & hard to implement but provides healthcare savings
■ Perinatal stage, childhood, adolescence, adulthood, older age
○ Distal determinants (affect proximal determinants) → poverty, inequality
○ Staged models (from prevention to treatment & care framework)
■ Early intervention is important → first episodes crucial, risk factors
○ Remission & recovery → CBT (mild), antidepressants (moderate/severe)
■ Combination works best
■ Non responders → electroconvulsive therapy
■ Spontaneous remission is possible
, ○ Self help & social interventions → moderate effect when guided
■ Support for lifestyle interventions, social not well studied
○ First line treatments → efficacy provent
■ Personal preference may moderate outcomes
■ Limitations → antidepressants have unwanted effects, withdrawal
○ Second & third line treatments → non response is common (50% do not achieve
remission in short term, treatment resistant depression)
■ Consider reasons for non response, safety of medications, subtype
■ ECT, TMS, GABA drugs (ketamine), mindfulness, ACT
○ Preventing relapse & recurrence → maintenance of pharmacotherapy
○ Problems with clinical practice vs RCT practice & results → wait list controls, high
heterogeneity, full treatment is completed in nonresponse, biases, comorbidities
○ Principles of care → same standards, only 10% receive effective care
■ Consider formulation, individual factors, good diagnostics
○ Collaborative care → team based health, social services, support services
■ Reaches underserved populations, family & person centered, low
resource availability, cost effective
Les avantages d'acheter des résumés chez Stuvia:
Qualité garantie par les avis des clients
Les clients de Stuvia ont évalués plus de 700 000 résumés. C'est comme ça que vous savez que vous achetez les meilleurs documents.
L’achat facile et rapide
Vous pouvez payer rapidement avec iDeal, carte de crédit ou Stuvia-crédit pour les résumés. Il n'y a pas d'adhésion nécessaire.
Focus sur l’essentiel
Vos camarades écrivent eux-mêmes les notes d’étude, c’est pourquoi les documents sont toujours fiables et à jour. Cela garantit que vous arrivez rapidement au coeur du matériel.
Foire aux questions
Qu'est-ce que j'obtiens en achetant ce document ?
Vous obtenez un PDF, disponible immédiatement après votre achat. Le document acheté est accessible à tout moment, n'importe où et indéfiniment via votre profil.
Garantie de remboursement : comment ça marche ?
Notre garantie de satisfaction garantit que vous trouverez toujours un document d'étude qui vous convient. Vous remplissez un formulaire et notre équipe du service client s'occupe du reste.
Auprès de qui est-ce que j'achète ce résumé ?
Stuvia est une place de marché. Alors, vous n'achetez donc pas ce document chez nous, mais auprès du vendeur lindej03. Stuvia facilite les paiements au vendeur.
Est-ce que j'aurai un abonnement?
Non, vous n'achetez ce résumé que pour 16,99 €. Vous n'êtes lié à rien après votre achat.
