Depressive d/o

Question 1

duration criteria for major depressive episode

Answer 1

at least 5 sx for at least 2 week period

Question 2

duration criteria for mania

Answer 2

at least 1 week

Question 3

duration criteria for hypomania

Answer 3

lasting at least 4 consecutive days

Question 4

diff btwn mania and hypomania

Answer 4

mania- lasts 7 days, causes severe impairment, may necessitate hospitalization, psychotic features

hypomania- lasts 4 days, NO imparirment in social or occupational fn, no hospitalization or psychotic features

Question 5

mixed features criteria

Answer 5

criteria met for mania or hypomania and at least 3 sx of MDE present for majority of the time for AT LEAST 1 WEEK

Question 6

MDD criteria

Answer 6

at least 1 MDE and no history of mania or hypomania

Question 7

Anhedonia

Answer 7

inability to experience pleasure

Question 8

MC sleep disturbance associated with MDD

Answer 8

difficulty falling asleep and early morning awakenings

Question 9

Etiology of MDD

Answer 9

low serotonin in CSF
high cortisol
abnormal thyroid axis

Question 10

If left untreated how long will depressive episodes last

Answer 10

6-12 mo

Question 11

Tx for MDD

Answer 11

1st line: SSRI/SNRI
TCAs
MAOI for refractory depression

Question 12

Most lethal antidepressant in OD

Answer 12

TCAs due to cardiac arrhythmias

Question 13

Adjunctive therapy for MDD

Answer 13

atypical APS

T3, T4, lithium

Question 14

When should ECT be used

Answer 14

pt unresponsive or unable to take pharmacotherapy, in pregnancy or if immediate suicide risk or catatonia

Question 15

melancholic features

Answer 15

more likely in severely ill pts

anhedonia, early morning awakenings, depression worse in AM, psychomotor disturbance, excessive guilt and anorexia

Question 16

atypical features

Answer 16

hypersomnia, hyperphagia, reactive mood, leaden paralysis, hypersensitivity to interpersonal rejection

Question 17

mixed features

Answer 17

manic/hypomanic sx present during majority of days during MDE

Question 18

catatonia

Answer 18

catalepsy (immobility), purposeless motor activity, extreme negativism or mutism, bizarre postures and echolalia

*esp responsive to ECT

Question 19

psychotic features

Answer 19

delusions/hallucinations

Question 20

triad for seasonal affective disorder

Answer 20

irritability
carbohydrate craving
hypersomnia

Question 21

tx for MDD w/ psychotic features

Answer 21

antidepressant, APS and ECT

Question 22

anxious distress

Answer 22

keyed up/tense, restless, difficutly concentration, fears of something bad happening and feelings of loss of control

Question 23

peripartum onset

Answer 23

onset during pregnancy of 4 weeks after delivery

Question 24

Bipolar I dsm5

Answer 24

only requires occurrence of manic episode (at least 1 week)

Question 25

rapid cycling

Answer 25

occurrence of 4 or more mood episodes in 1 year

Question 26

how long do untreated manic episodes last

Answer 26

several months

Question 27

tx for bipolar

Answer 27

mood stabilizers- lithium (dec suicide risk), carbamazepine, valproic acid
Atypical APS
Antidepressants w/ mood stabilizers for depression
ECT for manic episodes

Question 28

best tx for preg woman with mania

Answer 28

ECT

Question 29

persistent depressive disorder dsm5

Answer 29

depressed mood with 2 depressive sx lasting for 2 years and never a period >2 months without sx

Question 30

cyclothymic disorder dsm5

Answer 30

numerous periods with depressive sx and hypomanic sx that do not meet full criteria lasting for 2 years
cannot be without sx for >2 mo

Question 31

premenstrual dysphoric disorder treatment

Answer 31

SSRI = first line daily or starting on day 14 until menses

OCP, GnRH agonists

Question 32

disruptive mood dysregulation disorder

Answer 32

at least 3 outbursts per week verbal or physical
sx for at least 1 year with no more than 3 mo without sx
sx in at least 2 settings
sx start before age 10