Bipolar and Depressive Disorders Flashcards
As a treatment for major depressive disorder, _______ has the highest response and remission rates and fastest time to remission.
A. CBT
B. rTMS
C. ECT
D. SSRI
Answer C is correct. An advantage of ECT over the other treatments listed in the answers is that it has the highest response and remission rates and fastest time to remission.
Your new client, a 29-year-old physician’s assistant, describes experiencing alternating periods of hypomania that do not meet the criteria for a hypomanic episode and periods of depression that do not meet the criteria for a major depressive episode. To assign the diagnosis of cyclothymic disorder, the client must have experienced these symptoms for at least:
A. 6 months.
B. 1 year.
C. 18 months.
D. 2 years.
Answer D is correct. For the exam, you want to remember that the diagnosis of cyclothymic disorder and persistent depressive disorder both require a minimum duration of symptoms of 2 years for adults and 1 year for children and adolescents.
Research has found that the experience of depression is associated with:
A. hyperactivity in the ventromedial prefrontal cortex and dorsolateral prefrontal cortex.
B. hyperactivity in the ventromedial prefrontal cortex and hypoactivity in the dorsolateral prefrontal cortex.
C. hypoactivity in the ventromedial prefrontal cortex and hyperactivity in the dorsolateral prefrontal cortex.
D. hypoactivity in the ventromedial prefrontal cortex and dorsolateral prefrontal cortex.
Answer B is correct. Brain imaging studies have found that depression is associated with abnormally high levels of activity in the ventromedial prefrontal cortex (vmPFC) and abnormally low levels of activity in the dorsolateral prefrontal cortex (dlPFC). Note that a mnemonic for remembering this is to use the “l” in dlPFC to recall that depression is associated with a low level of activity in the dlPFC – and that the opposite (a high level of activity) occurs in the vmPFC.
Peter Lewinsohn’s model of depression is based on the principles of:
A. operant conditioning.
B. classical conditioning.
C. systems theory.
D. psychodynamic theory.
Answer A is correct. Knowing that Lewinsohn’s model is known as social reinforcement theory or that it describes depression as the result of a low rate of response-contingent reinforcement for social behaviors would have helped you identify operant conditioning (which emphasizes the role of reinforcement and punishment on behavior) as the correct answer.
A higher-than-normal level of melatonin has been linked to which of the following?
A. bipolar I disorder
B. bipolar II disorder
C. major depressive disorder with seasonal pattern
D. major depressive disorder with peripartum onset
Answer C is correct. Major depressive disorder with seasonal pattern is also known as seasonal affective disorder (SAD) and has been linked to a higher-than-normal level of melatonin, which is a hormone that’s secreted by the pineal gland and helps regulate the sleep-wake cycle.
Which of the following best describes the likely effects of electroconvulsive therapy (ECT) on memory when it is used as a treatment for severe depression?
A. Anterograde amnesia caused by ECT will be more persistent than retrograde amnesia.
B. Retrograde amnesia caused by ECT will be more persistent than anterograde amnesia.
C. ECT will produce transient anterograde amnesia but will not cause retrograde amnesia.
D. ECT will produce transient retrograde amnesia but will not cause anterograde amnesia.
Answer B is correct. ECT usually produces some degree of both anterograde and retrograde amnesia, with retrograde amnesia being more persistent: Anterograde amnesia ordinarily resolves within a few weeks after the last ECT session, while retrograde amnesia does not usually begin to resolve until after several weeks or months, with many patients experiencing persistent gaps in memory for events that occurred pre-ECT.
Which of the following symptoms is least useful for distinguishing bipolar disorder from ADHD in children and adolescents?
A. irritability
B. decreased need for sleep
C. hypersexuality
D. flight of ideas
Answer A is correct. Irritability is least useful because it is characteristic of both childhood and adolescent bipolar disorder and ADHD. The symptoms listed in answers B, C, and D are more characteristic of bipolar disorder than ADHD.
Which of the following best describes rates of depression for males and females?
A. The rates of depression for females are twice as high as the rates for males in childhood, adolescence, and adulthood.
B. The rates of depression for males are twice as high as the rates for females in childhood, but the rates for females are higher in adolescence and adulthood.
C. The rates of depression for males and females are similar during childhood but the rates for females are higher in adolescence and adulthood.
D. The rates of depression for males and females are similar during childhood, but the rates for males are higher in adolescence and adulthood.
Answer C is correct. Preadolescent boys and girls have similar rates of depression. However, after puberty, the rate for females increases while the rate for males remains fairly stable. As a result, female adolescents and adults have a rate that is 1.5 to 3 time higher than the rate for male adolescents and adults.
Ketamine has been found most useful for treating:
A. manic episodes.
B. atypical depression.
C. major depressive disorder with seasonal pattern.
D. treatment-resistant depression.
Answer D is correct. Ketamine has been found to be an effective treatment for treatment-resistant depression (TRD) and suicidal ideation. Definitions of TRD vary, but it is often defined as involving an inadequate response to at least two antidepressants from different classes.
Barton, a 20-year-old college sophomore, has come to therapy at the urging of his parents who are concerned about recent changes in his behavior. Barton tells you that, in the last six months, he’s experienced several periods in which he feels tired all the time despite sleeping more than usual, has trouble concentrating while reading for his classes and studying for exams, has low energy, and has no appetite. He says that each of the times he’s felt this way lasted for two or three weeks. The presence of which of the following will confirm a diagnosis of major depressive disorder for Barton?
A. recurrent suicidal ideation with a specific plan
B. a loss of interest or pleasure in most activities
C. feelings of guilt about past failures
D. slowed speech and thinking
Answer B is correct. To identify the correct answer to this question, you need to know that the DSM-5-TR diagnosis of major depressive disorder requires the presence of at least five characteristic symptoms with at least one symptom being a depressed mood or a loss of interest or pleasure in usual activities. Recurrent suicidal ideation, feelings of guilt, and slowed speech and thinking are symptoms of this disorder, but their presence is not required for the diagnosis.
