Lecture 3: Mood Disorders Flashcards

1
Q

What is the criteria for diagnosing a major depressive episode?

A
  • At least 5 of the following for a 2-week period with at least one either (1) depressed mood or (2) loss of interest or pleasure
  • SIG E CAPS
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2
Q

What is the criteria for diagnosis of a Manic Episode?

A
  • Abnormally and persistently elevated, expansile, or irritable mood lasting at least 1 week with at least 3 of the following:
  • Manics DIG FAST
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3
Q

What are the criteria for a hypomanic episode?

A
  • Similar to a manic episode but is less severe
  • Episodes last ≥4 consecutive days and no psychotic features
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4
Q

Diagnosis of major depressive disorder requires what?

A

Presence of one or more major depressive episodes and the absence of any manic, hypomanic, or mixed episodes

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5
Q

How do you tx depression that is tx resistant?

A

Electroconvulsive Therapy (ECT)

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6
Q

Why is it important to ask about family hx of mood disorders?

A

50% of pt’s with bipolar disorder have a 1st-degree relative with a mood disorder

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7
Q

Hypomanic episodes are more associated with which type of bipolar disorder?

A

Bipolar type II

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8
Q

What is the tx for normal grief (bereavement)?

A

Grief counseling; do NOT give them antidepressants

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9
Q

What is the most effective tx for depression and is often used in tx resistant cases?

A

Electroconvulsive Therapy (ECT)

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10
Q

Which pharmacologic agent can cause a 50% reduction in suicidal thoughts in 24-hours and is great for tx of major depressive disorder?

A

Ketamine

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11
Q

What is the criteria for persistent depressive disorder (dysthymia)?

A
  • Often milder, ≥2 depressive sx’s for most of the day2 years for adults and 1 year in children
  • During 2 years, cannot be w/o sx for >2 months at a time (is continuous)
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12
Q

Dysthymic disorder can be more difficult to tx what are some options?

A

CBT + Pharm: SSRIs, SNRIs, MAOIs

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13
Q

What is the criteria for Bipolar I Disorder?

A
  • ≥1 manic episode +/- a hypomanic or depressive episode
  • Major depressive episode not required, but is often the episode that presents first!
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14
Q

What is the criteria for Bipolar II Disorder?

A
  • Pt has at least one major depressive episode and one HYPOmanic episode in absence of any manic or mixed episodes
  • Hypomanic is the key!
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15
Q

What is the criteria for Cyclothymic disorder?

A
  • Characterized as dysthymic disorder (milder depression) w/ intermittent hypomanic episodes
  • ≥2 years (adults) and 1 year (children) experiencing repeated episodes of hypomania and depression (not severe enough to meet criteria for major depressive episode)
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16
Q

What is the tx for Cyclothymic Disorder?

A
  • Mood-stabilizing drugs
  • Supportive psychotherapy: CBT
17
Q

How do fluctuation of sx’s differ between generalized anxiety and those of panic anxiety disorder?

A

Sx’s of generalized anxiety fluctuate more than those of panic anxiety

18
Q

A diagnosis of panic disorder requires what?

A
  • Panic attack followed by ≥1 month of ≥1 of the following:
  • Persistent concern of additional attack
  • Worrying about consequencs of attack (i.e., losing control, MI, etc.)
  • Behavioral change related to attack
19
Q

How many signs/sx’s must be present for diagnosis of a panic attack and how long do they last?

A
  • Discrete period of intense fear or discomfort, in which ≥4 of the following developed abruptly: P3AN[ICS]3
  • Reach peak within 10 mins and usually last <25 mins
20
Q

Which type of anxiety disorder has a strong genetic component?

A

Panic disorder: 50% of all pt’s have at least one affected relative

21
Q

What is the criteria for Generalized Anxiety Disorder?

A
  • Excessive anxiety and worry about different aspects of life for most days of ≥6 months assoc. w/ ≥3 of the following:
  • Restlessness
  • Irratibility
  • Sleep disturbance
  • Fatigue
  • Muscle tension
  • Difficulty concentrating
22
Q

What is a big difference about patients perceptions of their actions with OCPD vs. OCD?

A
  • OCPD: pt does NOT perceive they have a problem
  • OCD: they know their compulsions and obsessions are not reasonable (most of the time)
23
Q

What is the duration of disturbance and sx’s for diagnosis of PTSD?

A

Lasts >1 month with significant distress or impaired functioning

24
Q

What is the tx for PTSD?

A
  • SSRIs and Venlafaxine
  • CBT