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Behavioral Medicine > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

Difference between yellow people and blue people

A

Serotonin transporter is like recycling device. has 2 genes. The long version is associated with resilience. If you have short alleles you are a blue person.

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2
Q

The genes you get determine your susceptibility to:

A

depression

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3
Q

If you grew up in benign childhood, the gene difference is lost. When your a parent…do a good job. Avoid physical discipline and reinforce the behavior you do want. This wipes out gene _____

A

difference

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4
Q

Who gets depressed when stressed men or women?

A

The men with 2 short alleles.

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5
Q

What is depression

A

SIG E CAPS: 5 or more s/x for more than 2 weeks

  1. Sleep
  2. Interests
  3. Guilt
  4. Energy
  5. Cognition
  6. Appetite
  7. Psychomotor
  8. Suicidal ideation
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6
Q

Subginual cingulate/Anterior cingulate gyrus comes up in studies of _____

A

depression; signals catemine responder

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7
Q

Nucleus cumins region is stimulated using DBS

A

know this

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8
Q

Where does depression come from

A
  1. biological: genetics
  2. environmental: childhood experience
  3. psychodynamic: repressed drives
  4. Psychological: automatic thoughts, mood congruent cognitions
  5. social: inescapable stress; stuck in a cage with a social superior, epigenetic changes
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9
Q

What is neuroplasticity

A

Tug of war between good and bad guys. About trophic (feed) and atrophic factors

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10
Q

Hippocampus is called hippocampus because it looks like a

A

seahorse

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11
Q

If you stay depressed, you get a hippoampal volume loss which is from neuron ____ and ____ loss

A

hippocampal; atrophy and neuron loss

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12
Q

What is neurogenesis

A

Active process of making new neurons. 6 weeks of daily restraint: cell number decreases by 13% and cell layer volume decreases by 5%

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13
Q

What is the molecular basis of depression

A

ask about this

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14
Q

Anti depressants promote _____

A

BDNF

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15
Q

stress methylates DNA and these epigenetic changes can be transmitted to human offspring. If your mom was stressed during pregnancy it makes you prone to stress before you are _____

A

born

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16
Q

2 short versions is not necessarily bad, your brain is more plastic and more responsible to react to _____

A

environment

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17
Q

What about alzheimers

A

Lithium is used to prevent it.

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18
Q

What is lifetime prevalence of depression

A

20%

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19
Q

what is the 12 month prevalence

A

6-9%

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20
Q

what is the prevalence of anxiety in a 12 month prevalence

A

18.1 %

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21
Q

What is the percentage of people with severe depression

A

4.3%

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22
Q

People who suffer from major depressive disorder fluctuate with their mood. People with dysthymic disorder are usually at a level ____. People with bipolar disorder 1 have ____episodes. People with bipolar disorder 2 have hypomanic episodes.

A

3; manic

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23
Q

Describe major depressive disorder

A

Episodes last more than 2 weeks with greater than 5 SIG E CAPS.

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24
Q

Dysthmia is chronic ___. Someone ends up with this gets this from alcoholism. Also awful childhoods

A

depression

25
Q

Describe Bipolar 1 Disorder

A
  1. Lasts more than 7 days
  2. Have manic episodes
  3. 3, 4 DIGFAST
26
Q

Describe Bipolar II Disorder

A
  1. Lasts more than 4 days
  2. 3, 4 DIGFAST
  3. hypermanic; less intense
27
Q

When you give antidepressants to someone, they don’t get manic. Its possible to have manic and depressive symptoms at the ____time. When you give someone antidepressants you get the induction of ____states

A

same; mix

28
Q

Mood experts think that the mechanism of antidepressants inducing suicides because antidepressants induce mix states not manic episodes. People want to get away from it, is by committing ____

A

suicide

29
Q

What are some things that cause depression

A
  1. Medical problems:
    - Thryoid
    - New medical problem
    - After age 30 w/o precipitating factor
  2. Medications
    - Interfereon, steroids
    - new
30
Q

What is depression associated with

A
  1. Risk factor for stroke, MI, Alzheimer’s
  2. Poorer outcomes after MI
  3. Poorer outcome in CHF
  4. Poorer outcome after orthopedic surgery
31
Q

What are atrophic factors:

A
  1. glutamate

2. cortisol

32
Q

What are trophic factors

A
  1. BDNF

2. bcl-2

33
Q

When you put DBS you put dampening frequency to dial down area. Too little activity in Brodman area 25 is associated with hypomania. Too much is associated with _____

A

depression

34
Q

T/F TMS increases BDNF

A

True

35
Q

Beta blockers is a depressagenic medication. T/F

A

False

36
Q

Interferons get it for Hepatitis C and is depressagenic. T/F

A

True

37
Q

How do you treat major depression

A

Depends on severity:
1. Patient preference
2. Psychotherapy as effective as meds (access and $ is a problem)
3.

38
Q

How do you quanitfy depression

A

PHQ-9; Max score is 27; Have to be ateast over 9 to be given an antidepressant

39
Q

What are three different ways to treat major depressive disorder

A
  1. Psychotherapies
  2. Medication
  3. “Natural”
40
Q

What are the different types of psychotherapies

A
  1. Psychodynamic
  2. CBT
  3. Interpersonal
  4. Supportive
  5. Mish-mash
41
Q

What are the med’s prescribed for people who have major depressive disorder

A
  1. Bupropion/Wellbutrin
  2. SRIs: prozac, and zoloft
  3. SNRIs
42
Q

what are 3 main meds given for major depressive disorder

A
  1. bupropion (weight neutral)
  2. fluoxetine/Prozac
  3. Sertraline/Zoloft
43
Q

Why isn’t bupropion as frequently prescribed for major depression

A

ask

44
Q

What is the STARD trial

A

ask

45
Q

What is the Natural way of treating Major depressive disorder

A
  1. fish oil
  2. st johns wort
  3. yoga
  4. light therapy
  5. Vitamin D
  6. an amazing array
  7. what I’m selling (inducing belief)
  8. what I utterly believe in
46
Q

What are not so natural ways of treating major depressive disorder

A
  1. Electroconvulsive therapy (ECT) -causes a seizure to happen every couple of seconds. Benefit lasts a long time
  2. Transcranial magnetic stimulation (TMS)
  3. Deep brain stimulation
47
Q

How do you treat dysthymia

A
  1. Try up to 3 different things

2. Psychotherapy

48
Q

How do you treat bipolar disorder 1

A
  1. diagnose
  2. mood stabilizers
  3. not AD’s
49
Q

How do you diagnose bipolar disorder 1

A

DIGFAST; find it in history of mania….incredible level of energy

50
Q

What does DIGFAST stand for

A
  1. distractability
  2. insomnia
  3. grandiosity
  4. flight of ideas
  5. activity (increased)
  6. speech (pressured)
  7. thoughtlessness
51
Q

MDQ is for mood disorder (questionnaire) and a handy way not to miss something and walk you through _____

A

DIGFAST

52
Q

Describe mania

A

A distinct period of persisently elevated, expansive, or irritable mood lasting throughout at least 7 days

53
Q

What are the non medication options for “mood stabilizers”

A
  1. sleep regularity
  2. “dark therapy”
  3. avoid substance use
  4. pt/family “concordance”
54
Q

What is dark therapy

A

put in dark room from 6 pm to 8 am…then went to 10 hours of darkness.

55
Q

what are standard mood stabilizers

A
  1. lithium
  2. valproate/divalproex/depakote
  3. carbamazepine/tegretol
  4. Lamotrigine (not antimanic)
56
Q

What are the atypical antipsychotics used for mood stabilizers

A
  1. olanzapine/zyprexa
  2. risperidone/invega
  3. quietiapine/seroquel
  4. aripiprazole/abilify
  5. ziprasidone/geodon
57
Q

what is the perfect medication for bipolar II disorder

A

lemotragine

58
Q

Describe hypomania

A
  1. increased activity
  2. increased energy
  3. increased optimism
  4. increased talkativeness
  5. decreased sleep
  6. increased self confidence

Behavioral Medicine (13 decks)

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