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PSYCH205: Clinical Psychology

Unit 6: Mood Disorders and Suicide   This unit will present different mood disorders, their etiologies, and their treatments across the lifespan. You will learn that though depression is the most common and the most widely known mood disorder, there are several others. In addition, this unit will present information regarding how mood disorders manifest in childhood, adulthood, and older adulthood, and the various treatment issues for these specific populations. This unit will also address suicide, a detrimental outcome that is closely tied to mood disorders, and an issue that is of major concern within clinical psychology.

Unit 6 Time Advisory
Completing this unit should take you approximately 9.25 hours.

☐    Introduction: 5 hours

☐    Subunit 6.1: 2.5 hours

☐    Subunit 6.2:  0.25 hours

☐    Subunit 6.3: 0.75 hours

☐    Subunit 6.4: 0.75 hours

Unit6 Learning Outcomes
Upon successful completion of this unit, you will be able to:
- list the various symptoms associated with each type of mood disorder;
  - identify relevant research/theories on the etiology of mood disorders; and
  - compare and contrast the manifestation of mood disorders in children and older adults as compared to adults.

  • Lecture: iTunesU: “Mood Disorders: Part I,” “Mood Disorders: Part II,” “Mood Disorders: Part III” The Saylor Foundation does not yet have materials for this portion of the course. If you are interested in contributing your content to fill this gap or aware of a resource that could be used here, please submit it here.

    Submit Materials

6.1 Mood Disorders in Adults   - Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health” Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999):** “Chapter 4: Adults and Mental Health” (PDF)
 
Instructions: Please click on the above link and read the section entitled “Mood Disorders.” If you would like, you can download the PDF version by scrolling down to the bottom of the page, clicking on “Contents,” and then selecting the PDF version of “Chapter 4: Adults and Mental Health,” which includes the section on mood disorders. Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. 

 This reading covers all topics listed under subunit 6.1. The
empirical journal article listed under subunit 6.1.2 will enrich
your understanding of diagnostic issues related to mood disorders in
adults.  

 Reading this text and taking notes should take approximately 1.5
hours.  

 Terms of Use: This material is part of the public domain. 

6.1.1 Complications and Comorbidities   *There are many complications and comorbidities associated with mental health in adults. Suicide (attempted and completed) is a major complication of adult mood disorders, and anxiety, depression, substance abuse, personality disorders, and medical illnesses (e.g., hypertension) are major comorbidities.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 244–245 for additional information.*

6.1.2 Assessment, Diagnosis, and Syndrome Severity   *Assessing/diagnosing mood disorders in adults involves differentiating among multiple illnesses including major depressive disorder, dysthymia, bipolar disorder, and cyclothymia. This differential diagnosis includes distinguishing causes such as medical conditions or medications that may influence mood disorder development and syndrome severity.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 245–251 and Drs. Stensland, Schultz, and Frytak’s article on “Depression Diagnosis Following the Identification of Bipolar Disorder: Costly Incongruent Diagnoses” for additional information.*

  • Reading: Biomed Central: The Open Access Publisher: Dr. Michael D. Stensland, Dr. Jennifer F. Schultz, and Dr. Jennifer R. Frytak’s (2008) “Depression Diagnoses Following the Identification of Bipolar Disorder: Costly Incongruent Diagnoses” Link: Biomed Central: The Open Access Publisher: Dr. Michael D. Stensland, Dr. Jennifer F. Schultz, and Dr. Jennifer R. Frytak’s (2008) “Depression Diagnoses Following the Identification of Bipolar Disorder: Costly Incongruent Diagnoses” (PDF)
     
    Instructions: Please click on the abovelink and read the introduction, methods, and discussion sections of this article.

    Reading this text and taking notes should take approximately 1 hour to complete.
     
    Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

6.1.3 Etiology of Mood Disorders   *The etiology of mood disorders is not thoroughly understood, but there are several aspects that influence mental illness development. Biological (e.g., abnormal neurotransmitter concentrations, monoamine hypothesis), genetic (e.g., relational in heredity, environment, values/beliefs), and psychosocial (e.g., stressful life events, cognitive factors, temperament/personality, gender) factors all influence adult mood disorder development.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 251–257 for additional information.*

6.1.4 Treatment of Mood Disorders   *The treatment of mood disorders is complex because it involves various stages. These stages (i.e., acute, continuation, and maintenance) apply to both pharmacotherapies and psychosocial therapies.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 257–261 for additional information.*

6.1.5 Specific Treatments for Episodes of Depression and Mania   *Specific treatments for episodes of depression and mania target symptom patterns rather than specific disorders. Regardless of the type of treatment for depression and mania (i.e., pharmacotherapies or psychosocial therapies), there are issues with service delivery, such as insurance benefits or management strategies.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 261–269 for additional information.*

6.2 Suicide   - Reading: National Institute of Mental Health’s “Suicide in the US: Statistics and Prevention” Link: National Institute of Mental Health’s “Suicide in the US: Statistics and Prevention” (PDF)
 
Instructions: Read this article to learn about suicide statistics and prevention in the United States. 
 
Reading this text and taking notes should take approximately 15 minutes. 
 
Terms of Use: The above material is in the Public Domain.

6.2.1 Risk Factors for Suicide   *Suicide risk factors vary with age, ethnicity, family history of mental disorders/substance abuse, and family violence, as well as additional aspects. These factors can occur in combination and also change over time. Research evidence has indicated that a change in neurotransmitter levels (e.g., serotonin) is a risk for suicide.

Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.*

6.2.2 Suicide in Different Groups   *Suicide risks are different for different groups of people. Comparing women and men, men are at a higher risk for suicide. Suicide in children/young people is also different depending upon age (e.g., young adults ages 20–24 are more likely to commit suicide than adolescents ages 15–19). Older adults are also likely to die by suicide, although this measurement is disproportionate to the national average. There are also significant differences in suicide risk among ethnicities.

Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.*

6.2.3 Prevention and Treatment   *Prevention of suicide should include treatment of major risk factors (e.g., mental or substance abuse disorders) and psychotherapy should be tailored to the individual. Pharmacotherapies should also be used to treat risk factors, and improvement in primary-care providers’ ability to recognize suicidal ideations should be emphasized.

Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.*

6.3 Mood Disorders in Children   - Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): "Chapter 3: Children and Mental Health" Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999):** "Chapter 3: Children and Mental Health" (PDF)

 Instructions: Read the section titled “Depression and Suicide in
Children and Adolescents.” Please note that the pages in the PDF bar
at the top of the document do not match the pages in the table of
contents section on the first page.   
    
 This reading will also cover the topics outlined for Subunits
6.3.1–6.3.6.  
    
 Reading this text and taking notes should take approximately 45
minutes.  
    
 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.

6.3.1 Conditions Associated with Depression   *There are many conditions in children and adolescents, such as anxiety disorders, anti-social disorders, and substance abuse disorders, that are associated with depression. These conditions, whether they occur individually or in combination, may indicate that depression is a response to the associated disorder, and that can increase the risk of suicide.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 150–151 for additional information.*

6.3.2 Prevalence   *The prevalence of depression and associated conditions in children and adolescents is variable and dependent on numerous factors, including age, symptom presentation, ethnicity, and gender.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 151–152 for additional information.*

6.3.3 Course and Natural History   *The course and natural history of depression and suicide in children and adolescents are influenced by age of onset and the effect of progression to adulthood. There is also a high risk of these individuals developing other mental disorders.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 152–153 for additional information.*

6.3.4 Causes   *There are many speculated causes of childhood and adolescent depression, but precise factors are not known. There is research evidence that family/genetic factors, gender differences, biological factors, cognitive factors, and risk factors for suicide/suicidal behavior all contribute to depression development.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 153–155 for additional information.*

6.3.5 Consequences   *The focus of both major depressive and dysthymic disorder is initial personal distress (e.g., death in the family, bullying). This initial distress can then lead to the impairment of many life aspects.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pg. 155 for additional information.*

6.3.6 Treatment   *Various options are available for treating mental disorders in children and adolescents. However, there are significant differences among treating depression, bipolar disorder, and suicide in this age group using pharmacological and psychosocial therapies.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 155–160 for additional information.*

6.4 Mood Disorders in Older Adults   - Reading: United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): "Chapter 5: Older Adults and Mental Health" Link: United States Department of Health and Human Services’ Mental *Health: A Report of the Surgeon General (1999):* "Chapter 5: Older Adults and Mental Health" (PDF)

 Instructions: Read the section titled “Depression in Older Adults.”
Please note that the pages in the PDF bar at the top of the document
do not match the pages in the table of contents section on the first
page.   
    
 Reading this text and taking notes should take approximately 45
minutes.  
    
 Terms of Use: Please respect the copyright and terms of use
displayed on the webpage above.

6.4.1 Diagnosis   *Depression in older adults often goes undiagnosed and untreated so it is crucial to accurately differentiate between conditions such as major and minor depression. It is also important to recognize that late onset depression can manifest disparate clinical characteristics. There are also prevalence and incidence patterns and issues with definitions and procedures to consider when diagnosing depression in older adults. Likewise, there are many barriers to diagnosing and treating depression including the complexity of medical/psychosocial contexts. Depression in older individuals should also be viewed across the lifespan in terms of progression, recurrence, and remission, and somatic illness interactions should be considered as reciprocal.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 346–350 for additional information.*

6.4.2 Consequences   *The consequences of depression in older adults include increased mortality from suicide and somatic illness, as well as a large economic burden due to various factors such as excess disability and frequent visits to medical facilities for treatment.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 350–351 for additional information.*

6.4.3 Etiology   *The etiology of depression in older individuals is not fully understood, but biological and psychosocial factors, in addition to other risk factors such as persistent insomnia, grief, or structural/neuroanatomical abnormalities, influence development of the disorder.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 351 for additional information.*

6.4.4 Treatment   *Numerous treatments are available to assist older adults in dealing with depression. Pharmacological therapies (e.g., tricyclics, SSRIs, multimodal therapy), electroconvulsive therapy, and psychosocial therapies (e.g., cognitive behavioral, problem solving, interpersonal, psychodynamic, and reminiscence) are all valid treatments for depression in the aging population.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 352–356 for additional information.*

The Saylor Foundation’s “Unit 6 Assessment”   - Assessment: The Saylor Foundation’s “Unit 6 Assessment” Link: The Saylor Foundation’s “Unit 6 Assessment”

 Instructions: Complete this unit assessment. For each question,
pick the best possible answer. The correct answers will be displayed
when you click the "Submit" button.  

 You must be logged into your Saylor Foundation School account in
order to access this quiz.  If you do not yet have an account, you
will be able to create one, free of charge, after clicking the
link.  

 Completing this assessment should take approximately 15 minutes.