4. Mood disorders Flashcards
Premedication for ECT
Atropine
Melancholic features of depression
Anhedonia Early morning awakenings Depression worse in morning Guilt Anorexia
Atypical depression features
hypersomnia
hyperphagia
Leaden paralysis
Hypersensitivity to interpersonal rejection
Catatonia
Catalepsy (immobility) Purposeless motor activity Extreme negativism or mutism bizarre postures Echolalia *Especially responsive to ECT
Triad for seasonal affective disorder
Irritability
Carbohydrate craving
Hypersomnia
Treatment for major depression with psychotic features
Antidepressant + Antipsychotic or ECT
Bereavement
Grief…the reaction to a major loss
NOT a mental illness
Episodes of major depression are not required for this diagnosis
Bipolar I
*The only requirement is the occurrence of a manic episode
This disorder has the highest genetic link of all major psychiatric disorders
Bipolar I
“Rapid cycling”
The occurrence of 4 or more mood episodes in 1 year
major depressive, hypomanic, or manic
Long-term use of this mood stabilizer reduces suicide risk
Lithium
Percent of people with bipolar disorder that attempt suicide
25-50 %
Best treatment for a pregnant woman who is having a manic episode
ECT
Treatment for Bipolar rapid cyclers
Carbamazepine
Gold standard for Bipolar disorder treatment
Lithium
Persistent depressive disorder
2D’s
2 years of depression
never asymptomatic for >2 months
Persistent depressive disorder (Dysthymia) symptoms
Concentration is poor Hoplessness Appetite is poor or overeats inSomnia or hypersomnia low Energy or fatigue low Self-esteem
“CHASES”
*Need at least 2 of them
Cyclothymic disorder
Alternating periods of hypomania and periods with mild-to-moderate depressive symptoms
*Hypomanic symptoms (but not fully hypomanic) and depressive symptoms (but not fully MDE) for at least 2 years
Chronic course of Cyclothymic disorder
Approximately 1/3 of patients eventually develop bipolar I/II disorder
Treatment of cyclothymic disorder
Mood stabilizers or 2nd generation antipsychotics
both are antimanic agents
Disruptive Mood Dysregulation Disorder
Chronic, severe, persistent irritability occurring in childhood and adolescence (must occur prior to 10 years of age)
