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Major Depressive Disorder: A Comprehensive Study Guide

This guide provides a comprehensive overview of bipolar and related mood disorders. It covers the diagnostic criteria for mania, hypomania, and mixed episodes, and explains the differences between Bipolar I, Bipolar II, and Cyclothymia. The guide also touches upon the BioPsychoSocial factors, epidemiology, and common comorbidities, offering insights into differentiating these conditions from DMDD.

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Depressive, Mood, and Suicide Risk Disorders

Introduction to Depressive Disorders

This material covers BioPsychoSocial factors, DSM-5-TR criteria for Major Depressive Disorder, and epidemiological components of various depressive disorders.

  • BioPsychoSocial model
  • Genetic vulnerability
  • Major Depressive Disorder DSM-5-TR criteria
  • SIGECAPS mnemonic
  • Depressive disorder epidemiology
  • Risk factors for depression
  • Disruptive Mood Dysregulation Disorder
  • Persistent Depressive Disorder
  • Premenstrual Dysphoric Disorder

Major Depressive Disorder Course and Specifiers

This content covers Major Depressive Disorder (MDD) including onset, prognosis, specifiers, and treatment options.

  • Major Depressive Disorder onset and duration
  • MDD prognosis and recurrence rates
  • Atypical features
  • Catatonic features
  • Peripartum onset
  • Seasonal pattern
  • Patient Health Questionnaire (PHQ-9)
  • Interpersonal Therapy

DSM-5-TR Depressive and Related Disorders

This content reviews DSM-5-TR criteria, epidemiology, and treatment for various depressive disorders including DMDD, Persistent Depressive Disorder, and PMDD.

  • Major Depressive Disorder
  • Disruptive Mood Dysregulation Disorder
  • Persistent Depressive Disorder
  • Premenstrual Dysphoric Disorder
  • Substance / Medication-induced Depressive Disorder
  • Depressive disorder due to another medical condition
  • Differential diagnosis
  • Psychosocial treatment interventions
  • Mental Status Exam
  • Dysthymia
  • Double depression

Clinical Presentation and Diagnosis of Depression

This content covers the differential diagnosis, clinical findings, and multidimensional aspects of depressive disorders, including substance-induced and medical condition-related types.

  • Substance/Medication-Induced Depressive Disorder
  • Depressive Disorder due to Another General Medical Condition
  • Grief and Bereavement
  • Differential Diagnosis of Depressive Disorders
  • Subjective Clinical Findings
  • Objective Clinical Findings
  • Psychomotor Retardation
  • Psychomotor Agitation
  • Masked Depression
  • DSM-IV-TR Multidimensional Aspects of Depression
  • Persistent Depressive Disorder
  • Mental State Examination

Mood and Related Disorders

A lecture covering Bipolar II, and Cyclothymic Disorders including BioPsychoSocial factors, epidemiology, and DSM-5-TR criteria.

  • BioPsychoSocial factors
  • Epidemiological factors
  • Manic episodes
  • Hypomanic episodes
  • Mixed episodes
  • Bipolar I Disorder
  • Cyclothymic Disorder
  • Disruptive mood dysregulation disorder
  • Major Depressive Disorder
  • Persistent Depressive Disorder
  • Premenstrual Dysphoric Disorder
  • Substance use disorders
  • Attention deficit hyperactivity disorder

DSM-V-TR Bipolar Episode Criteria

Diagnostic criteria for manic, hypomanic, and mixed episodes including DIGFAST manic symptoms and clinical impairment requirements.

  • Manic episode criteria
  • Hypomanic episode criteria
  • Mixed episode criteria
  • DIGFAST manic symptoms
  • Distractibility
  • Insomnia
  • Grandiosity
  • Flight of ideas
  • Activities
  • Speech
  • Thoughtlessness
  • Psychotic features
  • Impairment

Bipolar Spectrum Disorders and Clinical Characteristics

This lecture compares manic, hypomanic, and depressive symptoms to differentiate between Bipolar I Disorder, Bipolar II Disorder, and Cyclothymia Disorder.

  • Bipolar Disorder
  • Hypomania
  • Bipolar I Disorder
  • Cyclothymia Disorder
  • Disruptive Mood Dysregulation Disorder
  • Psychosis
  • Major depressive episode
  • Grandiosity
  • Decreased need for sleep

Bio-Psycho-Social Variables and Suicide Epidemiology

Review suicide epidemiology across the lifespan, identify bio-psycho-social variables, and evaluate risk factors for attempted suicide versus death by suicide.

  • Bio-Psycho-Social Model
  • Serotonin and 5-HIAA
  • Suicide epidemiology
  • Risk factors for death by suicide
  • Risk assessment for suicide attempt
  • Protective factors
  • Self-injurious behavior
  • Parasuicidal behaviors
  • Lethality
  • Impulsiveness and aggression

Suicide Risk Assessment and Evaluation

Assessment methods for suicide risk include family history, the 3 H's, the 4 P's, and the Patient Health Questionnaire (PHQ-9).

  • Family History
  • Depression
  • Bipolar disorders
  • Suicide attempts
  • Risk Assessment
  • Helplessness
  • Haplessness
  • Hopelessness
  • Psychiatric co-morbidity
  • Patient Health Questionnaire (PHQ-9)
  • Substance abuse
  • Personality disorders

Suicide Risk and Self-Injury Overview

This lecture covers suicide risk levels, self-injury behaviors, risk factors, warning signs, and protection against suicide.

  • High Risk suicide plans and intent
  • Parasuicidal behaviors
  • Self-Mutilation
  • Self-Injury
  • Suicide attempt rates
  • Protection against suicide
  • Suicide risk factors
  • Suicide warning signs

Clinical Presentation of Bipolar Disorders

Understand the clinical presentation of mania and hypomania, the course of Bipolar Disorders, and psychosocial treatments.

  • Bipolar Disorder
  • Hypomania
  • Cyclothymic Disorder
  • Bipolar I
  • Psychomotor hyperactivity
  • Flight of ideas
  • Grandiosity
  • Rapid cycling
  • Psychosocial treatments
  • Differential Diagnoses
  • Disruptive Mood Dysregulation Disorder

Psychiatric Evaluation, Interviewing, and Clinical Management

Psychiatric Evaluation and Mental Status Exam

Recognize the organization of a psychiatric evaluation and identify components of a mental status exam including mood, affect, thought process, and cognition.

  • Psychiatric evaluation organization
  • History of present illness
  • Psychiatric history
  • Substance use history
  • Developmental history
  • Mental status exam components
  • Appearance and hygiene
  • Dysmorphic features
  • Eye contact
  • Speech rate, rhythm, volume, and quantity
  • Pressure of speech
  • Motor mannerisms and tremors
  • Mood and affect
  • Thought process and form
  • Thought content and disturbances
  • Perceptual disturbances
  • Insight and judgment
  • Cognition

Mental Status Examination and BioPsychoSocial Formulation

Assessment of Mini-Mental State Exam and BioPsychoSocial formulation.

  • Judgment
  • Sensorium/Cognition
  • Concentration/Attention
  • Fund of Knowledge
  • Visuospatial Ability
  • Mini-Mental State Exam (MMSE)
  • Orientation
  • Registration
  • Levels of consciousness
  • Memory (Retrograde and Anterograde)
  • BioPsychoSocial Formulation
  • Biological Attributes
  • Psychological Attributes

Interviewing Skills and Psychotherapy Treatments

Describe interviewing skills applied in a clinical setting and discuss psychological and social treatments including indications and structure of psychotherapy.

  • Therapeutic alliance
  • Open-ended questions
  • Closed-ended questions
  • Gathering information
  • Mental status assessment
  • Psychotherapy
  • Supportive Therapy
  • Behavioral Therapy
  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Insight Oriented Therapy
  • Family Therapy
  • Marital Therapy
  • Therapeutic rapport building

Managing Difficult Patient Situations and News

Review protocols for managing difficult patient situations including breaking bad news, angry patients, demanding patients, and dependent patients.

  • SPIKES protocol
  • Breaking bad news
  • Angry patient characteristics
  • Management of an angry patient
  • Demanding patient characteristics
  • Management of the demanding patient
  • Dependent patient characteristics
  • Management of dependency
  • Professional boundaries

Managing Difficult Professional Patient Situations

Guidelines for managing patient anger, gift giving, romantic relationships, and ethical boundaries in clinical practice.

  • Acknowledging patient anger
  • Managing gifts and intent
  • Institutional gift policies
  • AMA code of conduct regarding romantic relationships
  • Confidentiality and social media invitations
  • Ethical boundaries with family members
  • Managing impaired physicians
  • Treating family members

SPIKES Protocol for Delivering Difficult News

The SPIKES protocol provides tips for giving difficult feedback and managing patient encounters through setting up the interview, assessing perception, invitation, knowledge, emotions, and strategy.

  • SPIKES protocol
  • Setting up the interview
  • Perception of the patient
  • Invitation
  • Knowledge delivery
  • Emotions and empathy
  • Strategy and summary
  • Shared decision-making
  • Patient rapport
  • Managing patient distress

BioPsychoSocial Model and Psychiatric Evaluation

The BioPsychoSocial Model encourages comprehensive understanding of disease through biological, psychological, and social systems to inform psychiatric evaluation and history.

  • BioPsychoSocial Model
  • Biological System
  • Psychological System
  • Social System
  • Psychiatric Evaluation
  • History of Present Illness
  • Past Psychiatric History
  • Substance Use History
  • Past Medical History
  • Family History
  • Developmental History
  • Social History

Psychotherapy Models, Personality Theory, and Psychological Testing

Psychotherapy and Behavioral Therapy Techniques

This material covers supportive psychotherapy goals and various behavioral therapy methods including systematic desensitization, flooding, implosion, token economy, and biofeedback.

  • Supportive Psychotherapy
  • Behavioral Therapy
  • Classical and Operant Conditioning
  • Systematic Desensitization
  • Aversive conditioning
  • Flooding
  • Implosion
  • Token Economy
  • Biofeedback
  • Progressive Relaxation
  • Exposure/Response Prevention

Cognitive and Dialectical Behavior Therapies

This content covers cognitive therapy, cognitive behavioral therapy, and dialectical behavior therapy including goals, implementation, and skills.

  • Cognitive Therapy
  • Cognitive distortions
  • Negative automatic thoughts
  • Cognitive Behavioral Therapy (CBT)
  • Behavioral modification
  • CBT Thought Record
  • Dialectical Behavior Therapy (DBT)
  • Mindfulness skills
  • Interpersonal effectiveness
  • Emotional regulation
  • Distress tolerance
  • Reality acceptance skills

Psychotherapy Models and Therapeutic Interventions

Overview of psychoanalysis, insight oriented therapy, group therapy, family/marital therapy, and specific clinical interventions.

  • Psychoanalysis
  • Freudian model
  • Free association
  • Dream interpretation
  • Transference reactions
  • Analysis of resistance
  • Insight oriented therapy
  • Group Therapy
  • Family/Marital Therapy
  • Systematic Desensitization
  • Dialectical behavioral therapy
  • Supportive therapy

Psychological Testing and Learning Theory

This content covers operant conditioning models, schedules of reinforcement, Freud's structural theory, defense mechanisms, and psychological testing indications.

  • Classical conditioning
  • Operant conditioning
  • Positive reinforcement
  • Negative reinforcement
  • Positive punishment
  • Negative punishment
  • Schedules of reinforcement
  • Continuous reinforcement
  • Interval schedule
  • Ratio schedule
  • Freud's structural theory
  • Defense mechanisms
  • Transference
  • Countertransference
  • Behavior and learning theory

Freudian Psychoanalytic Theory and Personality

This content explores Freud's topographical and structural models of personality, including the ego, id, superego, and defense mechanisms.

  • Topographical model
  • Structural model
  • Conscious
  • Preconscious
  • Unconscious
  • Id
  • Superego
  • Life instincts
  • Death instinct
  • Anxiety
  • Defense mechanisms

Psychological Defense Mechanisms and Transference

This material covers various defense mechanisms and the concepts of transference and countertransference.

  • Sublimation
  • Humor
  • Altruism
  • Suppression
  • Intellectualization
  • Rationalization
  • Isolation of affect
  • Displacement
  • Acting out
  • Undoing
  • Dissociation
  • Somatization
  • Identification
  • Splitting
  • Projection
  • Reaction Formation
  • Regression
  • Denial
  • Repression
  • Transference

Purposes and Methods of Psychological Testing

Psychological testing includes personality assessment, cognitive assessment, neuropsychological assessment, and IQ assessment to assist in diagnostic clarification, treatment recommendations, and forensic evaluations.

  • Psychological Testing
  • Personality Assessment
  • Projective Techniques
  • Objective Questionnaires
  • Cognitive Assessment
  • Neuropsychological Assessment
  • IQ Assessment
  • Aptitude versus Achievement
  • Learning Disabilities
  • Positive punishment

Human Behavior Course Introduction

An introduction to Human Behavior including course learning objectives, the DSM-V-TR, the BioPsychoSocial model, and psychiatric evaluation organization.

  • BioPsychoSocial model
  • DSM-V-TR
  • Psychiatric Evaluation
  • Psychiatric history
  • Mood disorders
  • Suicide risk assessment
  • Psychotherapies
  • Psychological testing
  • Defense mechanisms
  • Somatization disorder

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