Clin - Mood Disorders

Question 1

describe how relatives with mood or bipolar disorder increases a pt’s chance of having a mood disorder

Answer 1

• 10-35% of pts w/ mood disorder have a first degree relative with a mood disorder
• 50% of pts w/ bipolar disorder have 1st degree relative with bipolar disorder

Question 2

how are dopamine levels altered in depression and mania

Answer 2

• decreased in depression

- increased in mania

Question 3

how are 5-HT levels altered in depression

Answer 3

decreased in depression

Question 4

how are NE levels altered in depression

Answer 4

there is down-regulation of beta-receptors; noradrenergic function is abnormal in depression

Question 5

what type of neurotransmitter is GABA

how is it targeted to treat depression

Answer 5

inhibitory

it is the site of action for anxiolytic agents and benzos
–> GABA is activated

Question 6

what type of neurotransmitter is glutamate

how is it targeted to treat depression

Answer 6

excitatory

glutamate receptor NMDA is antagonized (blocked)

Question 7

list the kubler ross stages of grieving

Answer 7

denial –> anger –> bargaining –> depression –> acceptance

Question 8

what are the normal symptoms/conditions of bereavement

Answer 8

• recent loss of a loved one
• sx similar to major depressive disorder
• should not include hallucinations/delusions or impairment of function

Question 9

what are the contraindications to electroconvulsive therapy (ECT)

Answer 9

no absolute contraindications

Question 10

how does ketamine work

Answer 10

NDMA antagonist that produces dissociative anesthesia –> 50% reduction in suicidal thoughts in 24 hours

Question 11

what is “double depression”

Answer 11

dysthymic disorder and major depression occurring simultaneously

Question 12

describe the sx and tx for premenstrual dysphoric disorder (PMDD)

Answer 12

mood instability with anxiety, depression, irritability in the week before menses

tx: exercise, diet, relaxation therapy, SSRIs

Question 13

criteria for bipolar I disorder

Answer 13

• single manic episode is necessary to diagnose (at least one manic or mixed episode)
• major depressive episode not required to diagnose, but is usually what presents first

Question 14

treatment for bipolar disorders

Answer 14

1st line: mood stabilizers

• lithium
• valproic acid

Question 15

what are the psychological signs of an anxiety disorder

Answer 15

• apprehension, worry
• sense of doom or panic
• hypervigilence
• difficulty concentrating
• derealization (world seems strange)

Question 16

what are the somatic symptoms of anxiety disorder

Answer 16

HA, light-headed, dizzy, palpitations, lump in throat, restlessness, SOB, dry mouth, sweating

Question 17

physical signs anxiety disorder

Answer 17

• diaphoresis, cool/clammy skin
• tachy
• flushing
• hyperreflexia, tremor
• fidgeting

Question 18

compare obsessions and compulsions in OCD and related disorders

Answer 18

obsessions: recurrent and persistent thoughts, impulses, images
compulsions: repetitive behaviors or mental acts that the person feels drive to perform

Question 19

what is trichotillomania

Answer 19

hair pulling

Question 20

what is excoriation disorder

Answer 20

skin picking

Question 21

what is iatrophobia

Answer 21

fear of doctors

Question 22

what is acrophobia

Answer 22

fear of heights

Question 23

what are the 3 types of psychotherapy used to treat anxiety

Answer 23

• supportive therapy
• psychodynamic psychotherapy
• cognitive behavioral therapy (CBT)

Question 24

what are the sx of dysthymic diroder

Answer 24

CHASES

• concentration-poor
• hopelessness
• appetite-poor
• insomnia
• energy-low
• self-esteem-low