E1: Mood Disorders Flashcards
What must be present for a diagnosis of MDD?
1) Five or more symptoms present at least two week and at least one of the symptoms is either depressed mood or loss of interest or pleasure
2) Clinically significant impairment in social or occupational functioning
3) not due to physiological effects of substance abuse or GMC
4) not better explained by schizo
5) never has manic or hypomanic episode
What is the mnemonic for the symptoms of MDD?
Sig-E-Caps
- Sleep
- Interest
- Guilt
- Energy
- Concentration
- appetite
- Psychomotor changes
- SI
What is the questionnaire used to diagnose MDD?
- Patient Health Questionnaire 9 (PHQ-9)
- scoring of 0-27
What must be present for a diagnosis of Persistent Depressive disorder (dysthymia)?
1) depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by other for at least 2 years
2) presence, while depressed of at least two of the following: poor appetite, insomnia, low energy/fatigue, feeling of hopelessness, poor concentration
3) never been without symptoms for more than 2 months at a time
4) no mania
5) Not caused by schizo or GMC
6) significant distress and impairment
What does it mean when there is a response to treatment for depressive disorders?
There is >50% improvement in depressive symptoms
What does it mean when there is remission of depressive symptoms?
They are within a normal range of tests (PHQ-9 ≤4)
What are the treatment options for mild to moderate depressive disorders?
1) antidepressants
2) Psychotherapy
3) Combination therapy
What are the treatment options for severe depressive disorders?
1) Antidepressants
2) psychotherapy (CBT)
3) combination therapy
4) ECT
What is the main different between bipolar 1 and bipolar 2?
- Bipolar 1 has a distinct period of mania and abnormally elevated mood lasting at least 1 week
- Bipolar 2 has hypomaniac periods lasting a minimum of 4 days
What must be present for a diagnosis of Bipolar 1?
1) Criteria have been met for at least 1 manic episode
2) occurrence of manic and/or MDD episodes not better explained by schizo or delusions
What must be present for a diagnosis of mania?
1) distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week
2) marked functional impairment
3) not due to a drug
4) inflated self esteem or grandiosity, decreased need for sleep, more talkative, distractability, increase in goal directed activity
What is the mnemonic for the symptoms of mania?
DIGFAST
- Distractibility
- impulsivity
- grandiosity
- flight of ideas
- activity
- sleep
- talkative
What must be present for a diagnosis of Bipolar II?
1) presence of at least 1 hypomanic episode and 1 MDD episode
2) there has never been a manic episode
3) not better explained by schizo
4) depressive symptoms
What is the first line treatment for severe mania?
- First line: Lithium OR Depakote
- And a first generation atypical neuroleptic: Aripiprazole, risperidone, olanzapine, and quetiapine
What is the second and third line treatment for severe mania?
- Second line: different anticonvulsant and or different atypical
- Third line: ECT
What is the first line treatment of hypomania?
Risperidone or olanzapine
What is the second line treatment of hypomania?
-different atypical or first gen antipsychotic or anticonvulsant
What is the third line treatment of hypomania?
Benzos
