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Y3R3 - Psychiatry 🧠 > L5: Depressive Disorders > Flashcards

L5: Depressive Disorders Flashcards

1
Q

What is another name of mood disorders?

A

affective disorders.

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2
Q

What do Mood Disorders Include?

A
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3
Q

Unipolar & Dipolar Depression

A

Depression can occur alone or as part of bipolar disorder, When it occurs alone it is also known as unipolar depression.

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4
Q

Duration of depressive disorders

A

Symptoms must be present for at least 2 weeks and represent a change from previous functioning.

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5
Q

Incidence of Depressive diorders

A

More common in women than in men by 2:1. (F>M) (F:M = 2:1)

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6
Q

Precipitating events & Depression

A

Precipitating event occurs in at least 25% of patients.

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6
Q

Epidemeology of Depressive Disorders

A
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6
Q

DSM5 Cr of Major Depressive Disorder

A
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7
Q

Etiology of Depressive Disorders

A
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7
Q

Signs & Symptoms of of Major Depressive Disorder

A
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8
Q

Investigation in Depressive Disorders

A
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9
Q

what are subtypes of Major Depressive Disorder?

A
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9
Q

Characters of Persistent Depressive Disorder (Dysthymia)

A
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10
Q

Onset of Persistent Depressive Disorder (Dysthymia)

A

Insidious onset.

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11
Q

Duration of Persistent Depressive Disorder (Dysthymia)

A

2 Years

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11
Q

Incidence of Persistent Depressive Disorder (Dysthymia)

A
  • More common and chronic in women than in men. (F>M)
  • Occurs more often in persons with history of long-term stress or sudden losses
  • Often coexists with other psychiatric disorders.
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12
Q

Signs & Symptoms of Persistent Depressive Disorder (Dysthymia)

13
Q

Disruptive Mood Dysregulation Disorder

14
Q

Premenstrual Dysphoric Disorder

15
Q

Hallmark Symptoms of Premenstrual Dysphoric Disorder

16
Q

DDx of Depressive Disorder

17
Q

Suicide & Depressive Disorder

A

15% of depressed patients eventually commit suicide.

18
Q

How long does an untreated depressed episode last?

A

about 10 months.

19
Q

At least 75% of affected patients have …….

A

At least 75% of affected patients have a second episode of depression, usually within the first 6 months after the initial episode.

20
Q

average number of depressive episodes in a lifetime

20
Q

Prognosis of Depressive Disorder

A
  • 50% recover
  • 30% partially recover
  • 20% have a chronic course
21
Q

what are groups of antidepressants?

21
Q

Summary of TTT of Depressive Disorder

A
  • The most effective approach is to integrate pharmacotherapy with psychotherapeutic interventions.
  • Hospitalization: Indicated if patient is at risk for suicide, homicide, or is unable to care for him/herself.
22
Q

Selective serotonin reuptake inhibitors (SSRIs)

  • Advantages
  • Side Effects
A
  • Safer and better tolerated than other classes of antidepressants
  • Side effects are mild but include: headache, gastrointestinal disturbance, sexual dysfunction, and rebound anxiety.
23
Q

TCA

  • Disadvantages
  • Side Effects
A
  • Most lethal in overdose due to cardiac arrhythmias.
  • Side effects include: sedation, weight gain, orthostatic hypotension, and anticholinergic effects. Can aggravate prolonged QTc syndrome.
24
Q

MAOIs

  • Advantages
  • Adverse Effects
A
  • Older medications occasionally used for refractory depression.
  • Risk of hypertensive crisis when used with sympathomimetics or ingestion of tyramine-rich foods, such as: wine, beer, aged cheeses, liver, and smoked meats
25
Q

Medications that also have activation of other neurotransmitter include ….

26
Q

Characters of SNRIs in TTT of depression

A

Side effect: Increase blood pressure (contraindicated in hypertensive patients)

27
Q

Characters of a2-adrenergic receptor antagonist mirtazapine (Remeron) in TTT of depression

A
  • It has no sexual side effects
  • Side effect: sedation, postural hypotension, increase appetite and cause weight gain.
28
Q

Characters of dopamine-norepinephrine reuptake inhibitor: bupropion (Wellbutrin) in TTT of depression

A
  • It has no sexual side effects
  • Side effect: Decrease seizure threshold
29
Q

Adjuvant Medications in TTT of deperession

30
Q

Indications of ECT in Depression

A
  1. Unresponsive to pharmacotherapy
  2. Cannot tolerate pharmacotherapy (pregnancy, etc.)
  3. If rapid reduction of symptoms is desired (e.g., immediate suicide risk, homicide, refusal to eat/drink, catatonia).
  4. Emergency conditions (e.g. risk of suicide)
  5. Presence of psychotic features
31
Q

Procedure of ECT

32
Q

Psychological Therapy in Depression

32
Q

Side effects of ECT

A
  • Retrograde and anterograde amnesia are common side effects, which usually resolve within 6 months.
  • Other common but transient side effects: Headache, nausea, muscle soreness
33
Q

what are other modalities of Managment of Depression?

A

1- Deep brain stimulation
2- Transcranial Magnetic Stimulation
3- Vagus nerve stimulation

Y3R3 - Psychiatry 🧠 (19 decks)

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