BM - Mood Disorders Flashcards
What is the criteria for major depressive disorder
either depressed mood or loss of interest/pleasure (anhedonia) for a two week period, most of the day nearly every day plus 4 of the SIG E CAPS symptoms
What are the SIG E CAPS symptoms
- S/I, thought of death/plan/attempt
- Guilt/worthlessness
- Energy loss/fatigue
- Concentration/indecisiveness
- Appetite/Weight change
- Psychomotor agitation/retardation
- Sleep change
What is another requirement for MDD
Symptoms cause distress or impairment in areas of functioning; ex) not going to work
What are some specifiers of MDD
Peripartum onset - within 4 weeks of delivery, normal to a certain extent but can worsen
Seasonal pattern - Seasonal affective disorder, can use light therapy
“Depressed mood” can be:
“sad, hopeless, down”, somatic complaints/affect, loss of interest - “what kind of activities did you/do you do?”
How does depression typically present in children
Irritability, school, acting out, weight changes
How does depression typically present in the elderly
Somatic complaints, may deny depression, assess comorbid symptoms
What is the pathophysiology of depression
- Genetic/biological - neurotransmitters effected but not sure why
- Environmental
- Secondary to other diseases/conditions, inflammation, autoimmune, strokes, cancer, dimentia
What is dysthymic disorder
Depressed mood for most of the day, more days than not, for at least 2 years, by subjective or objective account; in children mood can be irritable, duration for 1 year
What are the symptoms of dysthymic disorder
- Low energy/ fatigue
- Poor concentration/ difficulty with decisions
- Poor appetite/overeating
- Insomnia/hypersomnia
- Low self-esteem*
- Hopelessness
What is the difference between MDD and dysthymic disorder
Dysthymic - “always been this way”
MDD - Hitting and point and going downhill when life was fine before
What is the criteria for a manic episode
distinct period of abnormally and persistently elevated, expansive, or irritable mood that lasts at least 1 week (or any duration if hospitalized); also need at least 3 symptoms
What are the symptoms in which 3 or more are needed to meet criteria for a manic episode
- Inflated self-esteem/grandiosity
- More talkative/pressure to talk
- Flight of ideas or racing thoughts
- Decreased need to sleep
- Distractibility
- Increase in goal directed activity or psychomotor agitation
- Excessive involvement in pleasurable activities that have a high potential for painful consequences (drinking, drugs, unprotected sex, spending sprees, etc.)
What is the social challenge of a manic episode
Symptoms cause marked impairment in occupational or social functioning, or symptoms necessitate hospitalization, or there are psychotic features
What is a criteria for bipolar disorder
Symptoms are not due to a substance or medical condition
What is the average age of onset for MDD and bipolar disorder
early - mid 20s
What do those with bipolar disorder believe
There is nothing wrong with them; poor insight
How do most bipolar disorder patients act
non-compliant
Compare the prognosis of MDD and bipolar disorder
Worse for those with bipolar disorder
What is very important to ask about for a patient with bipolar disorder
Family history
What are medical conditions that contribute to mood disorder
Parkinson’s disease, dementias, CVA, MS, Endocrine, lupus, RA, Cancer
What are examples of substance induced mood disorders
Prescriptions or illicit substances, cardiac meds, steroids, sedatives, anti-inflammatory
Describe the pharmacotherapy treatments for depressants
Antidepressants such as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors)
How long does it take for antidepressant medications to work
Several weeks/months to show full effects
