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NMSP Exam 3 > Clinical Approach to Mood Disorders > Flashcards

Clinical Approach to Mood Disorders Flashcards

1
Q

What is the most common psychiatric illness?

A

Depression

Higher in females

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2
Q

What happens to NE, Dopamine, 5-HT, and GABA in Major Depressive DO?

A

All decreased

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3
Q

What is the diagnostic criteria for MDD?

A

5 of the following for 2 weeks without any manic, hypomanic, or mixed episodes:

  1. Depressed mood
  2. Decreased interest in normal activities
  3. Weight Loss/Gain
  4. Insomnia
  5. Agitation/Retardation (slow throughout the day)
  6. Fatigue
  7. Worthlessness
  8. Can’t concentrate
  9. Thoughts of death and suicide
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4
Q

Examples of treatment for MDD

A 
TCAs
MAOi 
SSRI's 
Trazodone
Bupropion
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5
Q

What is Electroconvulsive Therapy?

A

Used for treatment-resistant depression

Series of shocks to the brain induce seizures to help “reset” patient.

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6
Q

Ketamine therapy for MDD

A

NMDA antagonist administered over a 45-60m infusion for treatment-resistant depression

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7
Q

Persistent Depressive Disorder (Dysthymia)

A

Depressed mood for at least 2 years in adults (1y in children) that is not severe enough to be MDD.
Cannot have withdrawal of symptoms for >2m

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8
Q

Depression with Seasonal Pattern (aka Seasonal Affective Disorder)

A

onset and remission of major depressive episodes that correspond with times of the year.
Symptoms of “Hibernation”- eating more and sleeping more
Tx: Light Therapy

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9
Q

Premenstrual Dysphoric Disorder (PMDD)

A

Mood instability the week before menses (cough.. Allison)

Tx: Exercise, Diet, Relaxation

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10
Q

What is defined as a manic episode?

A 
Elevated, Expansive, or irritable mood for >1w and 3 of the following: 
Inflated Self-Esteem
Decreased need for sleep
Pressured Speech
Racing thoughts
Goal-oriented behavior
Excessive pleasurable activities (sex)
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11
Q

Hypomanic Episode

A

Less severe and shorter time than a manic episode. Usually only 4 days and no psychotic features.
Not bad enough for mania, but bad enough for people to notice.

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12
Q

Bipolar I Disorder

A

A single Severe manic episode can be diagnostic. Major depressive episode not required as in Type II, but can be present.

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13
Q

Bipolar II Disorder

A

At least 1 depressive and 1 hypomanic episode. Tends to be more hypomania than full blown manic. More prevalent

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14
Q

2 mood stabilizing treatments that are 1st line for Bipolar Disorder

A

Lithium

Valproic Acid

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15
Q

Cyclothymic Disorder

A

Lesser form of Bipolar similar to Persistent Depressive Disorder. Patients have hypomanic and depressive periods over 2 years but do not meet criteria for BP.
Tx: Same as BP

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16
Q

What is generalized anxiety?

A

Persistent worry about actual circumstances, events, or conflicts of a person’s life. Could be “realistic” worries, such as bills, relationships, etc.

17
Q

Separation Anxiety

A

Recurrent stress when anticipating or experiencing separation from an attachment.
Refusal to go out from home
Fear of being alone
May have physical symptoms

18
Q

Panic Disorder

A
  1. Recurrent unexpected panic attacks AND
  2. 1 attack followed by 1 month of: fear of another attack or significant change in behavior because of attack

May have agoraphobia

19
Q

How long to Panic attacks usually last?

A

<25m with peak at 10m

Symptoms: Palpitations, sweating, tremor, SOB, CP, Dizziness

20
Q

Agoraphobia

A

Anxiety about being in situations where a person can only focus on how to escape it.
Example: fear of sitting in a movie theater not near the exit

21
Q

Social Anxiety Disorder

A

Fear and/or avoidance of social settings lasting at lead 6 months due to fear of embarrassment or humiliation.

22
Q

Generalized Anxiety Disorder

A 
excessive anxiety and worry for at least 6m with 3 of the following for most days: 
Restlessness
Fatigue
Irritability 
Muscle tension
Sleep disturbance
23
Q

OCD

A

Obsession- persistent thoughts and impulses to do something. (did i lock the door? am i sure? Should I check?)
Compulsion- Behavior or act a person must do to decrease distress or prevent some dreaded event. (I have to check or burglars will rob me)

24
Q

What is a major difference between OCD and OCPD?

A

A person with OCPD does not recognize their traits as a problem where as an OCD person knows their obsessions are unreasonable.
OCPD- CEO who is meticulous about branding
OCD- Guy who checks his stove 32 times before going to bed

25
Q

Examples of disorders related to OCD

A

Hoarding
Trichotillomania
Excoriation

26
Q

What is a phobia?

A

Intense fear of something that is excessive and unreasonable

27
Q

What is important to do before putting a mood disorder in your differential?

A

Rule out underlying substance, medication, or medical condition causing the problem.

NMSP Exam 3 (18 decks)

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