Chapter 4 pt 4 Flashcards
what is the pneumonic for the symptoms of persistent depressive disorder (dysthymia)
CHASES (2 or more of these) poor Concentration or difficulty making decisions feelings of Hopelessness poor Appetite or overeating inSomnia or hyperSomnia low Energy or fatigue low Self-esteem
what is the DSM-5 criteria for persistent depressive disorder (dysthymia)
depressed mood for the majority of time most days for at least 2 YEARS (in children and adolescence its one year)
at least two of the following
- poor concentration or difficulty making decisions
- feelings of hopelessness
- poor appetite or overeating
- insomnia or hypersomina
- low energy or fatigue
- low self-esteem
person has not been without the above symptoms for more than 2 months at at time
never had a manic or hypomanic episode
may have MDE or meet criteria for MDD continuously
what is the treatment of persistent depressive disorder
combination of psychotherapy and pharmacotherapy is more efficacious than either alone
COGNATIVE THERAPY
what is cyclothymic disorder
alternating periods of hypomania and period with mild-to-moderate depressive symptoms
what is DSM-5 criteria for cyclothymic disoerder
numbers period with hypomanic symptoms (but not full hypomanic episode) and periods with depressive symptoms (but not full MDE) for at least 2 YEARS
never have been symptoms free for more than 2 months in those 2 years
no history of MDE, hypomanic or manic episode
what is course and prognosis of cyclothymic disorder
chronic course
1/3 go one to develop a bipolar disorder
persistent depressive disorder is more common in whom
women
onset often childhood, adolescence, and early adulthood
how does one treat cyclothymic disorder
mood stabilizers (just like bipolar)
what is premenstrual dysphoric disorder
mood lability, irritability, dysphoria, and anxiety that occur repeatedly during the premenstrual phase of the cycle
what is DSM-5 criteria for premenstrual dysphoric disorder
in most menstrual cycles at least 5 symptoms are present: in the final week before menses, improve within a few days after menses, and are minimal/absent in the week postmenses
at least one of the following symptoms: affective lability, irritability/anger, depressed moos, anxiety/tension
at least one of the following for a total of 5 when combined: anhedonia, concentration, anergia, appetite, hypersomina, overwhelmed, physical symptoms (breast tenderness, joint/muscle pain, bloating, weight gain)
how does one confirm premenstrual dysphoric disorder
by daily ratings for at least 2 menstrual cycles
whats the course of premenstrual dysphoric disorder
may worsen prior to menopause but cease after menopause
what is treatment of premenstrual dysphoric disorder
SSROS 1st line
daily therapy or luteal phase-only treatment (start day 14 of cycle and stop upon menses)
OCP may reduce symptoms
what is DSM-5 criteria for disruptive mood dysregulation disorder (DMDD)
severe recurrent verbal and/or physical outbursts out of proportion to situation
outbursts more than 3x week and inconsistent with developmental level
mood between outbursts persistently angry/irritable most of the day nearly every day, and is observed by others
symptoms last for ONE YEAR and no more than 3 months w/o symptoms
symptoms in at least 2 settings
started b4 age 10
no episodes meeting manic or hypomanic episode for more than 1 day
what portion of kids with disruptive mood dysregulation disorder continue to meet criteria after 1 year
50%
