Bipolar and Depressive Disorders

Question 1

Changes from DSM IV to 5 on Bipolar Disorder diagnostic criteria now include

Answer 1

Changes in mood and changes in activity/energy. New specifiers of “with mixed features” and with anxious distress have been added.

Question 2

Changes from DSM IV to 5 on Depressive Disorders

Answer 2

A new diagnosis of Disruptive mood dysregulation disorder has been added for children up to 18 years who exhibit persistent irritability and episodes of behavioral dyscontrol. This came out of concern of over diagnosing children with Bipolar Disorder

Question 3

Changes from DSM IV to 5 on Depressive Disorders

Question 4

Changes from DSM IV to 5 on Depressive Disorders
————— Dysphoric Disorder is a new added diagnosis

Answer 4

Prementrual Dysphoric Disorder is a new added diagnosis

Question 5

Changes from DSM IV to 5 on Depressive Disorders
Dysthymia has been Subsumed under ——————— which also includes persistent major depressive disorder.

Answer 5

Dysthymia has been Subsumed under PERSISTENT DEPRESSIVE DISORDER which also includes persistent major depressive disorder.

Question 6

Changes from DSM IV to 5 on Depressive Disorders
A major depressive episode with at least three manic symptoms is typed as ————– ——– ———-

Answer 6

Changes from DSM IV to 5 on Depressive Disorders
A major depressive episode with at least three manic symptoms is typed as WITH MIXED FEATURES

Question 7

Changes from DSM IV to 5 on Depressive Disorders
The exclusion that major depressive disorder could not be diagnosed until at least 2 months after loss associated with ————–has been removed.

Answer 7

The exclusion that major depressive disorder could not be diagnosed until at least 2 months after loss associated with BEREAVMENT has been removed.

Question 7

Q: What are the key characteristics of a manic episode?

Answer 7

A: A manic episode involves an abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy for at least one week. It includes three or more symptoms such as inflated self-esteem or grandiosity, decreased need for sleep, and flight of ideas. It causes marked impairment in functioning, may require hospitalization to avoid harm, and/or includes psychotic features.

Question 8

Q: How is a hypomanic episode different from a manic episode?

Answer 8

A: A hypomanic episode also involves an abnormally and persistently elevated, expansive, or irritable mood; increased activity or energy; and three or more symptoms of mania for at least four consecutive days. However, symptoms are not severe enough to cause marked impairment in functioning, do not require hospitalization, and do not include psychotic features.

Question 9

Q: What are the criteria for a major depressive episode?

Answer 9

A: A major depressive episode requires five or more characteristic symptoms, with at least one being depressed mood or loss of interest or pleasure in most or all activities. Symptoms must last for at least two weeks and cause significant distress and/or impaired functioning.

Question 10

Q: What is required for a diagnosis of Bipolar I Disorder?

Answer 10

A: At least one manic episode that may or may not have been preceded or followed by one or more major depressive or hypomanic episodes.

Question 11

Q: What is required for a diagnosis of Bipolar II Disorder?

Answer 11

A: At least one hypomanic episode and at least one major depressive episode.

Question 12

Q: What is required for a diagnosis of Cyclothymic Disorder?

Answer 12

A: Numerous periods of hypomanic symptoms that do not meet the criteria for a hypomanic episode and numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode, lasting at least two years for adults or one year for children and adolescents.

Question 13

Q: What are the key hereditary findings related to Bipolar Disorder?

Answer 13

A: Twin, family, and adoption studies have confirmed a strong genetic component, with concordance rates of .67 to 1.0 for monozygotic twins and about .20 for dizygotic twins.

Question 14

Q: Which neurotransmitters are linked to Bipolar Disorder?

Answer 14

A: Norepinephrine, serotonin, dopamine, and glutamate.

Question 15

Q: What brain abnormalities are associated with Bipolar Disorder?

Answer 15

A: Structural and functional abnormalities in the prefrontal cortex, amygdala, hippocampus, and basal ganglia.

Question 16

Q: What circadian rhythm irregularities are linked to Bipolar Disorder?

Answer 16

A: Abnormalities in the sleep-wake cycle, hormone secretion, appetite, and core body temperature.

Question 17

Q: What are some evidence-based psychosocial interventions for Bipolar Disorder?

Answer 17

A: Family focused therapy, psychoeducation, interpersonal and social rhythm therapy, and cognitive-behavior therapy.

Question 18

Q: What pharmacotherapy is usually most effective for “classic Bipolar Disorder”?

Answer 18

A: Lithium.

Question 19

Q: What pharmacotherapy is usually most effective for “atypical Bipolar Disorder”?

Answer 19

A: Anticonvulsant and second-generation antipsychotic drugs.

Question 20

Q: What is required for a diagnosis of Major Depressive Disorder?

Answer 20

A: Five or more symptoms of a major depressive episode for at least two weeks, with at least one symptom being depressed mood or loss of interest or pleasure in most or all activities.

Question 21

Q: What is required for a diagnosis of Persistent Depressive Disorder?

Answer 21

A: A depressed mood with two or more characteristic symptoms (e.g., poor appetite or overeating, insomnia or hypersomnia, feelings of hopelessness) for at least two years in adults or one year in children and adolescents.

Question 22

Q: What is required for a diagnosis of Disruptive Mood Dysregulation Disorder?

Answer 22

A: Severe and recurrent temper outbursts that are verbal and/or behavioral, grossly out of proportion to the situation, occurring three or more times each week, and a persistently irritable or angry mood observable to others most of the day nearly every day for at least 12 months.

Question 23

Q: What are the DSM-5 specifiers for Major Depressive Disorder?

Answer 23

A: With peripartum onset and with seasonal pattern. Peripartum onset applies to symptoms during pregnancy or within four weeks after delivery. Seasonal pattern applies to mood episodes related to a specific time of year, typically winter.

Question 24

Q: How do depression rates vary by gender and age?

Answer 24

A: During childhood, rates are similar for boys and girls. In early adolescence, rates for females increase and remain higher than for males into adulthood. Female adolescents and adults have a rate 1.5 to 3 times higher than males.

Question 25

Q: What are some key findings from the National Survey on Drug Use and Health (NSDUH) regarding depression? (Highest rates by age)

Answer 25

A: From 2009 to 2017, the highest rates of depression were generally for ages 12 to 17, followed by ages 18 to 25, 26 to 49, and 50+. Rates increased substantially for younger age groups but remained relatively stable for older age groups.

Question 26

Q: What are some etiological factors linked to Major Depressive Disorder?

Answer 26

A: Heredity (genetic component), low levels of serotonin, dopamine, and norepinephrine, HPA axis abnormalities, and structural/functional brain abnormalities. Behavioral and cognitive factors include Lewinsohn’s social reinforcement theory, Seligman’s learned helplessness model, and Beck’s cognitive theory.

Question 27

Q: What are some age-related risk factors for Major Depressive Disorder?

Answer 27

A: For younger adults, genetics, stressful life events, and cognitive limitations. For older adults, chronic medical illness, decreased physical functioning, and social isolation.

Question 28

Q: How do the expression and experience of Major Depressive Disorder vary by age and cultural background?

Answer 28

A: Older adults more likely report somatic symptoms and cognitive changes. Non-Western cultures emphasize somatic symptoms, while Western cultures emphasize psychological symptoms.

Question 29

Q: What are some common comorbid disorders with Major Depressive Disorder?

Answer 29

A: Substance use disorders, anxiety disorders, personality disorders (especially borderline personality disorder), and coronary heart disease (CHD).

Question 30

Q: What are the treatment recommendations for Major Depressive Disorder by age cohort according to APA’s Clinical Practice Guideline?

Answer 30

A: For adolescents: CBT or IPT-A and fluoxetine. For adults: psychotherapy or second-generation antidepressants (SSRI or SNRI), and combined treatment of CBT or IPT plus antidepressants. For older adults: group-CBT or IPT plus second-generation antidepressants.

Question 31

Q: What is the effectiveness and limitation of St. John’s Wort for depression?

Answer 31

A: Effective for mild and moderate depression with fewer side effects than SSRIs, but not effective for severe depression and interacts with certain other drugs.

Question 32

Q: What are the suicide trends in the United States from 1999 to 2017?

Answer 32

A: Rates increased substantially, with higher rates for males. The highest rates for males were ages 75 and over, and for females ages 45 to 64. American Indians/Alaska Natives had the highest rates among individuals ages 15 to 44, while Whites had the highest rates among those 45 and older.

Question 33

Per DSM-5, other types of depression falling under the category of depressive disorders are:

Answer 33

Major Depressive Disorder
Persistent depressive disorder, formerly known as dysthymia
Disruptive mood dysregulation disorder
Premenstrual dysphoric disorder
Substance/medication-induced depressive disorder
Depressive disorder due to another medical condition
Other Specific/Unspecified depressive disorder

Question 34

what disorders fall under the category of bipolar disorders in the DSM 5

Answer 34

Bipolar I disorder
Bipolar II disorder
Cyclothymic disorder
Substance/medication-induced bipolar and related disorder
Bipolar and related disorder due to another medical condition
Other specified bipolar and related disorder
Unspecified bipolar and related disorder