Chapter 4 pt 1 Flashcards

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1
Q

what is a mood

A

description of one’s internal emotional state

both external and internal stimuli trigger moods

happy, sad, angry, irritable…

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2
Q

what is a mood epidosde

A

a distinct period of time in which some abdnormal mood is present

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3
Q

what is a mood disorder

A

defined by their pattern of mood episodes

MDD, bipolar I and II, persistent depressive disorder, cyclothymic disorder

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4
Q

what is the DSM V criteria for a major depressive episode

A

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

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5
Q

what is the DSM V criteria for a manic episode

A

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

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6
Q

what is a hypomanic episode

A

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

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7
Q

what are the differences in hypomania and mania

A
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
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8
Q

what is the pneumonic for symptoms of mania

A
DIG FAST
distractibility
insomnia/impulsive behavior
grandiosity
flight of ideas/racing thoughts
activity/agitation
speech (pressures)
thoughtlessness
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9
Q

what is the pneumonic for depressive symptoms

A
SIG E CAPS
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor activity
Suicidal Ideation
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10
Q

what is the definition of “mixed features”

A

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

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11
Q

what is the predominant mood state in mood disorders with MIXED FEATURES

A

irritably
these patients have poorer response to lithium
anticonvulsants are more helpful

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12
Q

what are some medical causes of a depressive episode

A

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)

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13
Q

what are some medical causes of mania

A

metabolic (hyperthyroidism)
neurological disorders (temporal lobe seizure, MS)
neoplasms
HIV

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14
Q

stroke patients are associated with a higher risk of developing what mood disorder and what is that related to

A

depression

poorer outcome overall

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15
Q

what is the most common mood disorder among those who complete suicide

A

MDD

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16
Q

what substances/medications induce Depressive disorder

A
EtOH
antihypertensives
barbs
corticosteroids
levodopa
sedative-hypnotics
anticonvulsants
antipsychotics
diuretics
sulfonamides
withdrawal from stimulants (cocaine, amphetamine)
17
Q

what substances/medications induce bipolar disorder

A
antidepressants
sympathomimetics
dopamine
corticosteroids
levodopa
bronchodilators
cocaine
amphetamines
18
Q

what is the DSM V criteria for major depressive disorder (MDD)

A

at least one major depressive episode

no history of mania or hypomania

19
Q

patients with depression may present to primary care and nor acknowledge their depressed mood but may express what

A

vague, somatic complaints (fatigue, headache, abdominal pain, muscle tension)

20
Q

what is the prevalence of MDD, peak age of onset

A

12% worldwide

peak onset in 20s

21
Q

what sleep problems are associated with MDD

A

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)

22
Q

what are the two most common sleep disturbances associated with MDD

A

difficulty falling asleep and early morning awakenings

23
Q

MDD is likely cased by what

A

neurotransmitter abnormalities in the the brain

24
Q

what are cortisol levels in MDD and what shows this

A

HIGH CORTISOL
hyperactivity of hypothalamic-pituitary-adrenal axis
shown by FAILURE TO SUPPRESS CORTISOL levels in dexamethasone suppression test

25
Q

what is the thyroid like in MDD

A

abnormal THYROID AXIS

horde disorders are associated with depressive symptoms

26
Q

what are the genetic links to depression

A

1st degree relatives are 2-4x more likely to have MDD

concordance with monozygotic twins is <40%

27
Q

about what percent of MDD patients get treatment

A

50%

28
Q

depression is common among patients with what type of cancer

A

pancreatic