Lecture 3: Mood Disorders Flashcards
What is the criteria for diagnosing a major depressive episode?
- 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
What is the criteria for diagnosis of a Manic Episode?
- Abnormally and persistently elevated, expansile, or irritable mood lasting at least 1 week with at least 3 of the following:
- Manics DIG FAST
What are the criteria for a hypomanic episode?
- Similar to a manic episode but is less severe
- Episodes last ≥4 consecutive days and no psychotic features
Diagnosis of major depressive disorder requires what?
Presence of one or more major depressive episodes and the absence of any manic, hypomanic, or mixed episodes
How do you tx depression that is tx resistant?
Electroconvulsive Therapy (ECT)
Why is it important to ask about family hx of mood disorders?
50% of pt’s with bipolar disorder have a 1st-degree relative with a mood disorder
Hypomanic episodes are more associated with which type of bipolar disorder?
Bipolar type II
What is the tx for normal grief (bereavement)?
Grief counseling; do NOT give them antidepressants
What is the most effective tx for depression and is often used in tx resistant cases?
Electroconvulsive Therapy (ECT)
Which pharmacologic agent can cause a 50% reduction in suicidal thoughts in 24-hours and is great for tx of major depressive disorder?
Ketamine
What is the criteria for persistent depressive disorder (dysthymia)?
- Often milder, ≥2 depressive sx’s for most of the day ≥ 2 years for adults and 1 year in children
- During 2 years, cannot be w/o sx for >2 months at a time (is continuous)
Dysthymic disorder can be more difficult to tx what are some options?
CBT + Pharm: SSRIs, SNRIs, MAOIs
What is the criteria for Bipolar I Disorder?
- ≥1 manic episode +/- a hypomanic or depressive episode
- Major depressive episode not required, but is often the episode that presents first!
What is the criteria for Bipolar II Disorder?
- Pt has at least one major depressive episode and one HYPOmanic episode in absence of any manic or mixed episodes
- Hypomanic is the key!
What is the criteria for Cyclothymic disorder?
- 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)
What is the tx for Cyclothymic Disorder?
- Mood-stabilizing drugs
- Supportive psychotherapy: CBT
How do fluctuation of sx’s differ between generalized anxiety and those of panic anxiety disorder?
Sx’s of generalized anxiety fluctuate more than those of panic anxiety
A diagnosis of panic disorder requires what?
- 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
How many signs/sx’s must be present for diagnosis of a panic attack and how long do they last?
- 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
Which type of anxiety disorder has a strong genetic component?
Panic disorder: 50% of all pt’s have at least one affected relative
What is the criteria for Generalized Anxiety Disorder?
- 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
What is a big difference about patients perceptions of their actions with OCPD vs. OCD?
- OCPD: pt does NOT perceive they have a problem
- OCD: they know their compulsions and obsessions are not reasonable (most of the time)
What is the duration of disturbance and sx’s for diagnosis of PTSD?
Lasts >1 month with significant distress or impaired functioning
What is the tx for PTSD?
- SSRIs and Venlafaxine
- CBT
