9990 · 1.2.3
Treatment and management of mood (affective) disorders flashcards
Revision flashcards for Cambridge 9990 Treatment and management of mood (affective) disorders (syllabus 1.2.3). Flip, recall, then mark a real past-paper question.
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How do SSRIs work?
Block serotonin reuptake at synapse — increased serotonin availability; takes 2–4 weeks for therapeutic effect.
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CBT for depression?
Identifies and challenges Beck's negative automatic thoughts and schemas — behavioural activation homework; targets maintaining cycle.
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IPT focus?
Interpersonal Therapy addresses role disputes, grief, role transitions, and interpersonal deficits — links mood to relationship problems.
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ECT procedure?
Brief electrical current under anaesthesia induces seizure — used for severe/treatment-resistant depression; mechanism unclear.
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ECT ethical issues?
Memory loss (retrograde amnesia), stigma, consent concerns — reserved for cases where benefits outweigh risks.
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Combined treatment?
CBT + SSRIs often more effective than either alone for moderate-severe depression — addresses cognitive and biological maintenance.
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What is the primary mechanism of action for SSRI antidepressants?
SSRIs (Selective Serotonin Reuptake Inhibitors) work by blocking the reuptake pump on the presynaptic neuron. This prevents serotonin from being reabsorbed, increasing its concentration in the synaptic cleft and enhancing neurotransmission.
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What is 'behavioural activation' in the context of CBT for depression?
A key component of CBT where the therapist and client work together to schedule and engage in activities that the client once found pleasurable or rewarding. This aims to counteract withdrawal and anhedonia, and provide positive reinforcement.
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Why is ECT considered a controversial treatment for depression?
Despite its high effectiveness for severe cases, ECT is controversial due to its invasive nature, the unclear mechanism of action, and significant potential side effects, most notably short-term confusion and both anterograde and retrograde memory loss.
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What is Beck's 'negative cognitive triad'?
A core concept in the cognitive model of depression. It refers to a set of three negative and automatic thought patterns: a negative view of the self (e.g., 'I am worthless'), a negative view of the world (e.g., 'Everything is against me'), and a negative view of the future (e.g., 'Things will never get better').
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What is the main advantage of combining antidepressants with CBT?
The combination creates a synergistic effect. Antidepressants can provide faster symptom relief, making it easier for the patient to engage in therapy. CBT then equips the patient with long-term coping skills, which can reduce the risk of relapse after medication is discontinued.
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What is the 'interactionist approach' to treating depression?
Combining biological (e.g., SSRIs) and psychological (e.g., CBT) treatments. The rationale is that medication can provide symptom relief, enabling better engagement in therapy, which provides long-term coping skills.
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Name a key study supporting combined treatment for depression.
The Treatment for Adolescents with Depression Study (TADS, 2004) found that a combination of fluoxetine (an SSRI) and CBT was significantly more effective than either treatment alone.
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What are the main limitations of using only antidepressants for depression?
They may not address the underlying psychological causes, leading to high relapse rates after discontinuation. They also have side effects (e.g., nausea, insomnia) that can lead to non-adherence.