Exam 2, Part 2

Question 1

What is Dysphoria

Answer 1

Unusually intense sad mood

Question 2

Depression is among the

Answer 2

5 MC disorders seen by a primary care physician

50% of cases go unrecognized by patient and the doctor

Question 3

who is most at risk for depression

Answer 3

Women Lifetime 20-25%

Men lifetime 7-12%

Question 4

In primary care settings what percent of the population has current major depression

Answer 4

6-10%

Question 5

Disability caused by depressive episodes rivals

Answer 5

Coronary artery disease

Question 6

Disability caused by depression is greater than that of

Answer 6

Chronic lung disease or arthritis

210.5 billion in US annually

Question 7

What are the 7 secrets of depression

Answer 7

1. Common
2. Often missed
3. Easy to diagnose if you know to look for it
4. Often severe
5. Often recurrent
6. Costly
7. Considered highly treatable

Question 8

What is the PHQ-9

Answer 8

Screening for depression only 10 questions so easy to evaluate

The higher the number the more severe the patients depression is

Max score is 27

Question 9

Major depressive disorder is two categories

Answer 9

Single episode

Recurrent

Lifetime prevalence adults 16.6%

Question 10

MDD is diagnosed by

Answer 10

At least 2 weeks of depressed mood or loss of interest in nearly all activities for most or all of the day

AND at least FOUR additional symptoms
Changes in appetite or weight
Insomnia or hypersomnia 
Agitation or retardation 
Fatigue or loss of energy
Feelings of worthlessness or guilt
Difficulty thinking, concentrating, or making decisions 
Recurrent thoughts of death and suicide

Question 11

How common after a first major depressive episode is it that they will have another one

Answer 11

50%

Untreated episodes lasts about 6-24 months

Question 12

Dysthymia is

Answer 12

Depressive disorder involving chronic depression of less intensity than major depressive disorder

Requires only 3 of the listed symptoms, but they must be present for at least 2 years

Question 13

Disruptive mood dysregulation disorder (DMDD)

Answer 13

A depressive disorder in children who exhibit chronic and severe irrability and frequent temper outbursts

Outburst must be developmentally inappropriate and occur > 3 x a week

Question 14

Premenstrual dysphoric disorder (PMDD)

Answer 14

Women who experience depressed mood or changes in mood during premenstrual phase.

Has to be a true HIGHLY exaggerated mood disturbance

Question 15

Who is MC for bipolar disorder

Answer 15

1 parent with disease- 25-30%

2 parents with disease- 50-75%

Mean age of first impairment 18.7 years

Question 16

What is bipolar disorder

Answer 16

Manic episodes and very disruptive experiences of heightened mood (EUPHORIC) possible alternating with major depressive episodes

Question 17

What is a manic episode

Answer 17

A period of EUPHORIC mood with symptoms involving abnormally heightened levels of thinking, behavior, and emotionality.

Question 18

Hypomanic episode is

Answer 18

A period of ELATED MOOD not as extreme as a manic episode

Question 19

Criteria for a manic episode

Answer 19

Lasting at least 1 week and present most of the day nearly every day and having >3 of the following symptoms

Inflated self esteem or grandiosity
Decreased need for sleep
More talkative than normal
Flight of ideas as subjective racing thoughts
Distractibility reported or observed
Increased goal directed activity
Excessive involvement in activities with painful consequences

Question 20

What is Bipolar 1 disorder

Answer 20

One or more manic episodes, and possibility of major depressive episodes

More Mania than depression

Question 21

Bipolar 2 disorder is

Answer 21

One or more major depressive episodes and at least one hypomanic episode

More Depression than mania

Question 22

Cyclothymic disorder is

Answer 22

Symptoms are more chronic and less sever than those with bipolar disorder

Question 23

Criteria for cyclothymic disorder

Answer 23

Meet the criteria for a hypomanic episode

Numerous periods of depressive symptoms

NEVER meet the criteria of a major depressive episode

Lasts AT LEAST 2 years

Question 24

Medication for depression and bipolar disorder

Answer 24

SSRI’s, SNRI’s, TCAs, MAOI’s

Lithium******* for Bipolar disorder specifically

Question 25

True or False suicide is a diagnosable disorder

Answer 25

FALSE

Question 26

Difference between men and women about suicide

Answer 26

Men fewer attempts, more lethal

Women more attempts, less lethal

Question 27

Who is MC for suicide

Answer 27

45-54 yrs old

40,000 suicide a year in US

Question 28

Suicide is common in this untreated disorder

Answer 28

Bipolar

25-50% of patients attempt suicide at least once

MC in spring and autumn

Question 29

What are the 5 key component to suicide risk

Answer 29

1. Ideation
2. Intent
3. Plan
4. Access to lethal means
5. History of past attempts