11-14 Mood Disorders Flashcards
• Students will learn the DIAGNOSTIC CRITERIA for the major mood disorders • Students will learn the PREVALENCE, societal IMPACT and RISK FACTORS for the major mood disorders • Students will learn the potential COURSE and PROGNOSIS of various mood disorders • Students will learn the general CLASSES OF TX for mood disorders
Define and give examples of mood EPISODES:
Episode: acute presentation – Major Depressive Episode (MDE) – Manic Episode – Hypomanic Episode – Mixed Episode **note episode is NOT disorder
Define and give examples of mood DISORDERS:
Disorder: pattern of episodes over time
– MDD, Bipolar I, Bipolar II, cyclothymia, dysthymia
– Single Episode or Recurrent (with or without interepisode recovery)
– Patients in remission (ø symptoms); still have disorder
dysthymia, briefly
not all the criteria for MDD
—consistent >2yrs
—no more than two months w/o sx in that time
adjustment d/o, briefly
not all the criteria for MDD
—short-term
—response to stressor w/in 3 mos
pseudobulbar affect, briefly
“I don’t know why I’m crying all the time!”
—affect w/o mood
—Parkinson’s, AD, HD
DDx for MDD
—hypothyroidism
—tx w/ IFN
—bipolar (really impt to r/o b/c anti-depressants can cause mania!); can dx BPD even w/ only 1 manic episode
Major Depressive Episode Dx Criteria
—mnemonic
MUST HAVE ONE OF: —1. depressed mood —2. anhedonia PLUS 3 NEUROVEGETATIVE SX: Sleep ↓ or ↑ Interest Guilt/worthless Energy low Concentration/Cognition Appetite Psychomotor retardation/agitation Suicidal
MDD w/ Atypical Depression Qualifier
Mood Reactivity
—2+ of: wt gain, HYPERsomnelence, leaden paralysis, interpersonal rejection sensitivity
—MAOIs>TCAs
MDD w/ Melancholic Qualifier
• Severe anhedonia:
– Loss of pleasure in almost all activities, AND/OR
– Absence of reactivity to previously pleasurable stimuli
• 3+ of:
– Distinctive quality of depressed mood (NOT normal
sadness)
– Depression worse in the AM (diurnal pattern)
– Early morning awakening (>2 hrs before normal time)
– Marked psychomotor retardation/agitation – Significant anorexia or weight loss
– Excessive or inappropriate guilt
Tx: early b/o suicide risk; TCAs or ECT
MDD w/ Catatonic Qualifier
MDE w/ 2+ of:
– Catalepsy or stupor
– Purposeless, excessive motor
——Distinguish from hypo-/mania (e.g., mixed epi)
– “Extreme negativism”, resistance to all movement, mutism
– Voluntary abnormal posturing, stereotypies, “mannerisms”, grimacing
– Echolalia or echopraxia
“Baby Blues vs. Post-Partum Depression
• “Baby blues” (NOT post-partum depression):
– Up to 70% of women post-partum
– Occurs within 10 days of delivery
– Transient
– DOES NOT impair function (excludes MDE)
• Post-partum depression:
– Full criteria for MDE are met
– Occurs within 4 weeks post-partum
– Can be psychotic or non-psychotic
Mania vs. Hypomania?
Mania = sx > 1 wk; significant dysfunction Hypomania = sx > 4 days; limited dysfunction
Manic Sx MNEMONIC
Distractibility Irresponsibility Grandiosity Flights of Ideas Activity↑ Sleep↓ Talkative/pressured speech
BPD I
—1 manic/mixed episode
—no need for prior depressive!
—more severe than BPD II
BPD II
—MDE
—hypomanic episode
—Less severe than BP I; difficult to diagnose
