Bipolar Disorder And Depression Flashcards
What are the DSM-5-TR diagnostic criteria for Major Depressive Disorder? What are the two key symptoms, one of which must be present for the diagnosis?
A. A presence of a SINGLE major depressive episode. At least 5 symptoms during the same 2-week period that represent a change from previous functioning, with at least one being depressed mood or loss of interest/pleasure:
- Depressed mood *
- Anhedonia *
- Appetite changes
- Changes in sleep
- Changes in psychomotor
- Changes in energy
- Low self-esteem (and guilt)
- Loss of concentration
- Suicidality or thoughts of death
B. Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
(Key symptoms starred)
What is the definition of anhedonia?
Loss of interest or pleasure
INCOMPLETE What is a Research Domain Criteria document (RDoC)?
What is the prevalence of Depressive Disorders in the US?
Average of 16 % across the lifetime (males 12% and females 20%)
What are the risk factors for developing a depressive disorder?
Childhood emotional abuse and/or neglect
Increased stress/traumatic event
Age
Family history
Race
Comorbid disorder (anxiety, substance use, impulse control)
What is the gender distribution in the general population and in school aged children?
Adults: Effects more women (20% versus 12% in males)
School-age Children: effects boys and girls equally
How may depression present in children, adolescents and in the elderly population?
Children: School phobia, clinging to parents
Adolescents: acting out, poor academic performance, running away, irritability
Elderly: somatic complains, cognitive impairment, suicidality
What are the consequences of Depressive Disorders in terms of work, social dysfunction, leisure, ADLs/IADLs, cognitive functioning, psychomotor functioning, coping, problem-solving skills, suicidality and other medical conditions?
Increased mortality, more sick days, leading cause of disability, increased suicidality, susceptible to other mental illnesses and medical conditions (lung cancer, cardiac illness)
What are characteristics of mixed feature depression?
Greater than or equal to 3 manic/hypomanic symptoms present nearly every day during the majority of days during a major depressive episode
(And doesn’t meet criteria for hypomania or mania)
What are effective treatments for Depressive Disorders?
Medications, DBT, CBT
How serious is the threat of suicide in the US?
VERY! 2/3 of individuals who die by suicide suffer from some form of depression
Why is suicide assessment an essential part of a psychiatric assessment by the psychiatrist and the occupational therapist?
To determine safety of the individual and make a plan to keep them safe including removing access to means and constructing a protective safety plan
What is the basis of people’s fears of discussing suicide with a suicidal client?
Fear that asking will increase the risk of the person attempting suicide (NOT TRUE!!!)
What is the difference between passive and active suicidal ideation?
Passive: “I don’t want to live but I don’t want to take my life”
Active: Thoughts about taking life (does NOT need a plan!)
What are 3 questions that you could ask to assess the nature, frequency, depth, timing, and/or persistence of suicidal thinking?
Have you ever had thoughts that life was not worth living?
Have you ever had thoughts about hurting yourself or taking your life?
What is the closest you’ve come to acting on those thoughts?
What steps should an OT student take if they hear a client express suicidal ideation?
Ask the 3 questions
Help develop a safety plan
What is dysthymia?
Mild persistent depression
In the DSM, what is the difference between Bipolar I and II disorders?
Bipolar I does not require 2 weeks of depression for diagnosis; only requires 1 week of mania or any duration if hospitalized
Bipolar II requires BOTH 2 weeks of depression AND at least 4 days of hypomania
What are the clinical features of Mania?
A. Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any direction if hospitalization is necessary)
B. 3 or more (4 if mood is only irritable):
- grandiosity
- decreased need for sleep
- flight of ideas/racing thoughts
- Distractibility
- increase in goal-directed activity or psychomotor agitation
- high potential for painful consequences activities
C. Marked impairment in social/occupational functioning or hospitalization or psychotic features
What is hypomania?
A. Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day (or any direction if hospitalization is necessary)
B. 3 or more (4 if mood is only irritable):
- grandiosity
- decreased need for sleep
- flight of ideas/racing thoughts
- Distractibility
- increase in goal-directed activity or psychomotor agitation
- high potential for painful consequences activities
C. Change in functioning uncharacteristic when not symptomatic
D. Disturbance observable by others
E. No marked impairment, hospitalization, or psychotic features
What is Cyclothymic Disorder?
A “milder”version of Bipolar; multiple episodes but not severe enough
What is the prevalence of Bipolar disorders (BD)?
Bipolar 1: 1%
Bipolar 2: 1.1%
Other Bipolar: 2.4%
What is the typical age range of onset for BD?
Average is 25
Bipolar 1: 18
Bipolar 2: Mid-20s
What is the typical course of BD in terms of time spent depressed versus manic?
Bipolar 1: 53% asymptomatic, 32% depression, 9% manic, 6% cycling/mixed
Bipolar 2: 46% asymptomatic, 50% depression, 1% manic, 2% cycling/mixed
