11-5 Flashcards
mood WITHOUT abnormally high mood periods
Depressive Disorders
> 1 major depressive episode (MDE) and cannot have a history of mania or hypomania (never swings to opposite mood)
Major Depressive Disorder
unipolar depression
Major Depressive Disorder
2 weeks of >5 affective, neuro-vegetative, or cognitive symptoms
Major Depressive Episode
Affective symptoms of MDE
depressed mood
anhedonia (lack of pleasure)
Neuro-vegetative symptoms of MDE
significant weight change
in/hypersomnia
loss of energy
Cognitive symptoms of MDE
psychomotor changes
feeling guilty/worthless
decreased concentration
thoughts of death/suicidal ideation
Risk of developing MDD
gen. pop. = 10%
relative (1st degree) = 20%
MZ co-twin with MDD = 30%
MDD Neurobiology
^ Amygdala
^ HPAA
^ Cortisol
^ Cytokines
v Hippocampus
v Prefrontal Cortex
v Monoamines (dopamine & serotonin)
psychotherapy (CBT) and antidepressants (^ serotonin and norepinephrine)
MDD treatments
most popular class of ADs with benign side effects (ex: Fluoxetine AKA Prozac)
SSRIs
not as affective as SSRIs but also has benign side effects
ex: Venlafaxine AKA Effexor
SNRIs
Serotonin and Norepinephrine reuptake inhibitors, less serotonin and more norepinephrine, cardiac side effects
TCAs (Tricyclic Antidepressants)
prevent enzyme degradation, diet restrictions to avoid tyramine-induces hypertension
MAOIs
must experience at least 1 maniac episode, symptoms >1 wk (or hospitalization) that case marked impairment in functioning,
Bipolar I Disorder (BPI)
abnormally elevated mood (or irritability) PLUS increased energy and 3 additional symptoms
Manic Episode
Manic episodes without MDE (uncommon)
Manic episodes with alternating MDE (common)
BPI
Risk of developing BPI
gen. pop. = 1%
relative (1st degree) = 20%
MZ co-twin with BPI = 80%
more genetically controlled than MDD and manic episodes involve increased monoaminergic activitiy
BPI
Mood stabilizer: treatment of Manic Episodes
lithium
anticonvulsants
antipsychotics
treatment of bipolar MDEs
antidepressants with mood stabilizer
ONLY FDA-approved drugs for BP depression
antipsychotics (different for those used to treat mania)
experiencing at lease 1 MDE and 1 hypomanic episode
Bipolar II Disorder
does not cause marked impairment in function, changed of mood uncharacteristic of person and last >4 days
Hypomanic episode
MDEs with hypomania
BPII
the more disruptive problem in BPII
depressed phase
treatment same as BPI with focus on bipolar depressive drugs
BPII treatments
> 2 years, experiences periods of hypomanic symptoms that fluctuate with periods of depressive symptoms
Cyclothymic Disorder
similar to BPI but mood shifts are not as extreme
Cyclothymic Disorder
treated with mood stabilizers just like BPI
Cyclothymic Disorder
alternating symptoms of dysthymic and hypomanic
Cyclothymic Disorder
Mnemonic for MDE
SIG-E-CAPS:
sleep change
interest loss
guilt
energy problem
concentration poor
appetite change
psychomotor changes
suicidal ideation
chronic depression, dysthymia and/or MDEs for 2+ yrs without interceding euthymia during that period
Persistent Depressive Disorder
Premenstral mood lability
Premenstrual Dysphoric Disorder
severe and persistent irritability in child
Disruptive Mood Dysregulation Disorder
Mania (always) + MDE (usually)
BPI
MDE + hypomania
BPII
Hypomanic + Dysthymic symptoms
Cyclothymia
Mnemonic for Manic Symptom
DIG FAST:
Distractibility
Iressponsibility
Gradiosoity
Flight of ideas (racing thoughts)
^ Activity (goal-direct)
v Sleep
Talkativeness
