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Psych > 2. Mood disorders > Flashcards

2. Mood disorders Flashcards

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1
Q

Mood disorders vs. mood episodes?

A

Mood disorders = PATTERNS of mood episodes (ex. MDD, BP1, BP2, dysthymic disorder, cyclothymic disorder); some may have psychotic features

Mood episodes = distinct PERIODS OF TIME in which some abnormal mood is present (ex. depression, mania, mixed-state, hypomania)

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2
Q

Symptoms of major depression

A

(SIGE CAPS)

  • sleep (insomnia or hypersomnia)
  • interest (anhedonia)
  • guilt
  • energy (loss of energy/fatigue)
  • concentration (less)
  • appetite (either up or down)
  • psychomotor activity (agitation or reardation - restlessness or slowness)
  • suicidal ideation
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3
Q

Major depressive episode criteria

A

at least 5 of symptoms (SIGE CAPS) and must include either depressed mood or anhedonia for AT LEAST 2 wk period
- must cause social/occupational impairment

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4
Q

Symptoms of mania

A

(DIG FAST)

  • distractability
  • insomnia/impulsive behavior
  • grandiosity
  • flight of ideas/racing thoughts
  • activity/agitation
  • speech (pressured)
  • thoughtlessness
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5
Q

What is manic episode?

A

Period of abnormally and persistently elevated, expansive, irritable mood for AT LEAST 1 wk (or any duration if hospitalization is necessary)
- at least 3 of DIG FAST

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6
Q

What is mixed episode?

A

criteria met for both manic episode and major depressive episode; present nearly every day for at least 1 week
- this is psychiatric emergency! (like manic episode)

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7
Q

Difference b/w hypomanic episode and manic?

A
  • hypomania lasts for at least 4 days (manic - 7 days)

- hypomania does not have marked impairment in social or occupational functioning

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8
Q

Mixed episode tx?

A

poorer response to lithium. anticonvulsants may help

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9
Q

medical causes of manic episode?

A

metabolic (hyperthyroidism), neurological disorders (temporal lobe seizures, multiple sclerosis), neoplasms, HIV infection

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10
Q

What are stroke pts at high risk of developing?

A

depression

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11
Q

Difference in prevalence of MDD in men and women

A
  • twice as prevalent in women during reproductive years

- equal prevalence b/w men and women after menopause and before menses

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12
Q

What are some sleep problems associated w/ MDD?

A
  • most common: initial and terminal insomnia (hard to fall asleep and early morning awakenings)
  • multiple awakenings
  • hypersomnia
  • REM sleep shifted to earlier in night and stages 3 and 4 decreased
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13
Q

Some etiology (neurotransmitters) of depression

A
  • decreased neurotransmitters (serotonin)
  • high cortisol (hyperactivity of HPA axis)
  • abnormal thyroid axis (thyroid disorders associated w/ depressive symptoms)
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14
Q

Genetic components of MDD?

A
  • 1st deg relatives 2-3x more likely
  • monozygotic twins = 50-70%
  • dizygotic twins = 10-25%
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15
Q

What is the risk of a subsequent major depressive episode if left untreated?

A

50% within first 2 yrs after 1st episode

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16
Q

What % of patients respond to antidepressants?

A

50-60%

17
Q

What are common side effects of ECT?

A
  • retrograde and/or anterograde amnesia (usually goes away in 6 months)
  • headache, nausea, muscle soreness (more transient)
18
Q

Features of atypical depressive disorder?

A
  • hypersomnia
  • hyperphagia
  • reactive mood
  • leaden paralysis (heavy feeling in legs)
  • hypersensitivity to interpersonal rejection
19
Q

What is the Kubler-Ross model of grief? (5 stages)

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
20
Q

What can be given for normal grief?

A
  • mild benzodiazepines for sleep
21
Q

What is the definition of rapid cycling?

A

occurrence of 4 or more mood episodes in 1 yr (major depressive, manic, mixed, etc)

22
Q

What is the requirement for the diagnosis of BP1 disorder?

A
  • occurrence of 1 manic or mixed episode

- episode of major depression NOT required for the diagnosis

23
Q

What is the likelihood of first-deg relative of a pt w/ BP disorder likely to get BP?

A

8-18times

24
Q

Which major psychiatric disorder has the highest genetic link?

A

bipolar 1

25
Q

What is the course and prognosis of untreated manic episode?

A
  • untreated manic episode usually lasts about 3 months

- course is usually chronic w/ relapses

26
Q

What % of individuals after 1 manic episode will have a repeat manic episode within 5 yrs?

A

90%

27
Q

What can be given as prophylaxis b/w manic episodes to help decrease the risk of relapse?

A

lithium prophylaxis

28
Q

What % of BP1 pts commit suicide vs. % for MDD?

A

25-50% with BP disorder; 15% with MDD

29
Q

Symptoms of dysthymic disorder

A

CHASES

  • poor Concentration or difficulty making decisions
  • feelings of Hopelessness
  • poor Appetite or overeating
  • inSomnia or hypersomnia
  • low Energy or fatigue
  • low Self-esteem
30
Q

Which is more prevalent - BP1 or BP2?

A

BP2

  • but less studies on the tx of BP2
  • so tx is the same as BP1 until further studies
31
Q

What is dysthymic disorder?

A

Chronic mild depression most of the time w/ no discrete episodes

  • at least 2 yrs
  • 2 listed criteria (CHASES); but no major depressive episode
  • never asymptomatic for >2months
  • rarely need hospitalization
32
Q

What is double depression?

A

Pts w/ MDD with dysthymic disorder during residual periods

33
Q

What is the prognosis of dysthymic disorder?

A
  • 20% will develop major depression
  • 20% develop BP disorder
  • > 25% have lifelong symptoms
34
Q

What is cyclothymic disorder?

A

Alternating periods of HYPOMANIA and periods w/ mild-moderate depressive symptoms

  • at least 2 yrs
  • never symptom free for >2 months during the 2 yrs
  • no hx of major depressive episode or manic episode
35
Q

What is the triad for seasonal affective disorder?

A
  • irritability
  • carb craving
  • hypersomnia
36
Q

What is the difference b/w adjustment disorder and PTSD?

A
  • Adjustment disorder: stressful event is not life threatening (ex. divorce, death of a loved one, loss of a job)

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