Chapter 4 pt 1 Flashcards
what is a mood
description of one’s internal emotional state
both external and internal stimuli trigger moods
happy, sad, angry, irritable…
what is a mood epidosde
a distinct period of time in which some abdnormal mood is present
what is a mood disorder
defined by their pattern of mood episodes
MDD, bipolar I and II, persistent depressive disorder, cyclothymic disorder
what is the DSM V criteria for a major depressive episode
at least FIVE of the following symptoms for at least a 2 WEEK period (must have 1 or 2):
1. depressed mood most of the time
2. anhedonia (loss of interest in pleasurable things)
3. change in appetite or weight
4. feelings of worthlessness or excessive guilt
5. insomnia or hypersomnia
6. diminished concentration
7. psychomotor agitation or retardation
8. fatigue or loss of energy
9. recurrent thoughts of death or suicide
symptoms not attributable to substance or other medical condition
what is the DSM V criteria for a manic episode
distinct period of abnormally and persistently elevated, expansive, or irritable mode and abnormally and persistently increased goal-directed activity or energy, lasting at LEAST 1 WEEKS ( or ANY DURATION IF HOSPITALIZATION is necessary) AND at least THREE of the following (4 if mood is only irritable):
1. distractibility
2. inflated self-esteem or grandiosity
3. increase in goal directed activity (socially, work, or sexually) or psychomotor agitation
4. decrease need for sleep
5. flight of ideas or racing thoughts
6. more talkative than usual or pressured speech
7. excessive involvement in pleasurable activities that have high risk of negative consequences
not attributed to substance or other medical condition
what is a hypomanic episode
distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasted FOUR CONSECUTIVE DAYS and has at LEAST THREE of the SYMPTOMS for manic episode (4 if mood is only irritable)
1. distractibility
2. inflated self-esteem or grandiosity
3. increase in goal directed activity (socially, work, or sexually) or psychomotor agitation
4. decrease need for sleep
5. flight of ideas or racing thoughts
6. more talkative than usual or pressured speech
7. excessive involvement in pleasurable activities that have high risk of negative consequences
not attributed to substance or other medical condition
what are the differences in hypomania and mania
mania: -lasts at least 7 days -causes severe impairment in social or occupational functioning -may necessitate hospitalization -may have psychotic features hypomania: -no marked impairment in social or occupational functioning -does not require hospitalization -NO PSYCHOTIC FEATURES
what is the pneumonic for symptoms of mania
DIG FAST distractibility insomnia/impulsive behavior grandiosity flight of ideas/racing thoughts activity/agitation speech (pressures) thoughtlessness
what is the pneumonic for depressive symptoms
SIG E CAPS Sleep Interest Guilt Energy Concentration Appetite Psychomotor activity Suicidal Ideation
what is the definition of “mixed features”
criteria are met for a manic or hypomanic episode and at least 3 symptoms of major depressive spades are present for a majority of the time
must be present NEARYL EVERY DAY for at LEAST WEEK
what is the predominant mood state in mood disorders with MIXED FEATURES
irritably
these patients have poorer response to lithium
anticonvulsants are more helpful
what are some medical causes of a depressive episode
cerebrovascular disease (stroke, MI)
endocrinopathies (DM, Cushing, Addison, hypoglycemia, hyper/hypothyroidism, hyper/hypocalcemia)
Parkinson’s
Viral illnesses (mono)
carcinoid syndrome
cancer (especially lymphoma and pancreatic carcinoma)
collagen vascular disease (SLE)
what are some medical causes of mania
metabolic (hyperthyroidism)
neurological disorders (temporal lobe seizure, MS)
neoplasms
HIV
stroke patients are associated with a higher risk of developing what mood disorder and what is that related to
depression
poorer outcome overall
what is the most common mood disorder among those who complete suicide
MDD
what substances/medications induce Depressive disorder
EtOH antihypertensives barbs corticosteroids levodopa sedative-hypnotics anticonvulsants antipsychotics diuretics sulfonamides withdrawal from stimulants (cocaine, amphetamine)
what substances/medications induce bipolar disorder
antidepressants sympathomimetics dopamine corticosteroids levodopa bronchodilators cocaine amphetamines
what is the DSM V criteria for major depressive disorder (MDD)
at least one major depressive episode
no history of mania or hypomania
patients with depression may present to primary care and nor acknowledge their depressed mood but may express what
vague, somatic complaints (fatigue, headache, abdominal pain, muscle tension)
what is the prevalence of MDD, peak age of onset
12% worldwide
peak onset in 20s
what sleep problems are associated with MDD
multiple awakenings
initial and terminal insomnia
hypersomnia (less common)
REM sleep shifted earlier in the night and for greater duration (reduces sages 3 and 4 (slow wave) sleep)
what are the two most common sleep disturbances associated with MDD
difficulty falling asleep and early morning awakenings
MDD is likely cased by what
neurotransmitter abnormalities in the the brain
what are cortisol levels in MDD and what shows this
HIGH CORTISOL
hyperactivity of hypothalamic-pituitary-adrenal axis
shown by FAILURE TO SUPPRESS CORTISOL levels in dexamethasone suppression test
what is the thyroid like in MDD
abnormal THYROID AXIS
horde disorders are associated with depressive symptoms
what are the genetic links to depression
1st degree relatives are 2-4x more likely to have MDD
concordance with monozygotic twins is <40%
about what percent of MDD patients get treatment
50%
depression is common among patients with what type of cancer
pancreatic
