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NB3 (last of MS1) > Lecture 4+5+DLA > Flashcards

Lecture 4+5+DLA Flashcards

1
Q

with melancholic features (mood disorder)

A

lack of mood reactivity, despondency and guilt

depression worse in the morning

early morning awakening

major loss of appetite

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2
Q

with atypical features (mood disorder)

A

weight increase
sleep increase
mood reactivity
leaden paralysis

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3
Q

with psychotic features (mood disorder)

A

can be depressive or manic episodes that also have delusions and hallucinations

mood-congruent psychotic features:
congruent with typical themes of that mood state

mood-incongruent psychotic features:
does not involve typical themes of that mood state

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4
Q

with catatonia (mood disorder)

A

have psychomotor symptoms

mutism 
immobility 
waxy flexibility 
stereotypes 
odd posture
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5
Q

with peri-partum onset (mood disorder)

A

depressive or bipolar disorders in which the mood episodes onset during pregnancy or within 4 weeks post-delivery

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6
Q

with seasonal pattern (mood disorder)

A

Used for depressive or bipolar disorders that show a consistent temporal relationship between time of year and the mood episode

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7
Q

with rapid cycling (mood disorder)

A

Used for bipolar disorders in which >4 mood

episodes occur per year

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8
Q

Persistent Depressive Disorder (PDD)

A

must be chronically depressed for more than 2 years

can be a long-lasting major depressive episode

or

dysthymia: chronic depressed mood and 2 or more of the following symptoms: 
poor appetite / over eating 
insomnia or hypersomnia
low energy 
low self-esteem  
hopelessness 
low concentration

can be:
with persistent MDE

pure dysthymic syndrome (No MDE)

intermittent MDE

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9
Q

treatment for PDD

A

The same psychotherapeutic and pharmacological methods used for MDD are used for the “dysthymic” subtype of PDD

Brain stimulation therapies used for depression may also be used for PDDs that involve treatment-resistant and/or severe MDEs

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10
Q

Premenstrual Dysphoric Disorder (PMDD)

A

present in the week before menses onset
improve a few days after menses onset
minimize in the week post-menses

symptoms:
mood lability, irritability, dysphoria, anxiety
physical symptoms, sleep change, appetite change, lethargy

must lead to functional impairment

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11
Q

treatment for PMDD

A

several SSRI’s are approved for PMDD

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12
Q

Disruptive Mood Dysregulation Disorder

DMDD

A

Severe temper outbursts at least 3 times/week
Sad, irritable or angry mood almost daily
Reaction is disproportionate to situation
Symptoms are present in multiple settings

the child must be at least 6 years old
symptoms must begin before age 10
cannot diagnose after 18!

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13
Q

Electroconvulsive Therapy (ECT)

A

Involves electrical induction of a generalized seizure

A patient is pre-treated with a muscle relaxant to prevent injury and an anesthetic to reduce consciousness

treatment for depression and or mania

has many and indiscriminate effects on CNS

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14
Q

Repetitive Transcranial Magnetic Stimulation (rTM)

A

stimulate the pre frontal cortex

given to those who have failed at least 1 medication trial

minimal side effects

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15
Q

Vagus Nerve Stimulation (VNS)

A

Intermittent electrical stimulation of the vagus
nerve

used for treatment resistant depression
mild effects of stimulation
takes several months to be working

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16
Q

Experimental Brain Stimulation Therapies

A

Magnetic Seizure Therapy (MST)

focal seizure induction
reduce memory side effects that you get from ECT

deep brain stimulation (DBS)

for OCD
several target sites

17
Q

Major depressive disorder (DDD)

A

also known as unipolar depression

must have had at least one major depressive episode
cannot have a history of mania or hypomania
(go between euthymic and depressed)

18
Q

major depressive episode (MDE)

A

at least two weeks with 5+ of the following symptoms

affective:
depressed mood
anhedonia (lack of joy)

neurovegetative:
weight change
sleep disturbance (more/less)
loss of energy

cognitive: 
psychomotor changes
guilty/ worthlessness 
less concentration 
thoughts of death
19
Q

MDE and sleep

A

decreased REM latency
increased REM time
decreased SWS or N3

20
Q

MDD etiology and neurobiology

A

social and physical stress will trigger this
good coping skills may prevent this

high amygdala activity
high HPA activity (increased cortisol levels and increased cytokines)

decreased gray matter volume in the parahippocampal gyrus and hippocampus

deceased monoamines 
decreased dorsolateral perfrontal cortex (less activity) 
smaller hippocampus (due to high cortisol?)
21
Q

what are the SSRI’s

A

Fluoxetine, citalopram, sertraline

side affects: GI disturbance and sexual dysfunction

blocks the reuptake of 5-HT

22
Q

the SNRI’s

A

Venlafaxine, duloxetine

similar side affects as SSRI’s, but increase BP

blocks reuptake of 5-HT and norepi

23
Q

Tricyclic Antidepressants

A

Imipramine, amitriptyline

block the presynaptic reuptake of NE and 5-HT

cardiac side effects (hypotension)

Less serotonin agonism relative to the SSRI and SNRI

Also blocks histamine, muscarinic (anticholinergic),
alpha-1 receptors (thus cardiac symptoms)

24
Q

MAOI Antidepressants

A

Phenelzine, selegiline

prevent the enzyme from breaking down monoamine transmitters (5-HT, NE, Dopamine)

less used

diet restriction; no tyramine (cheese)

25
Q

other antidepressant treatments

A

Esketamine nasal spray
rapid onset effects
blocks NMDA receptors

phototherapy:
exposure to bright artificial light
good for seasonal affective disorder

brain stimulation

26
Q

bipolar I disorder

A

have at least one manic episode

symptoms must be more than 1 week ( any duration if needed hospitalization)

must lead to impaired functioning
can also have MDE’s

27
Q

manic episode def

A

Abnormally elevated mood OR irritability AND increased energy 3+ additional symptoms

inflated self-esteem 
decreased need for sleep 
flight of ideas
distracted
more risky activates
28
Q

Bipolar II disorder

A

at least one major depressive episode
and at least one hypomanic episode

change in mood must be uncharacteristic

hypomanic episode must be 4+ days

29
Q

hypomania def

A

No psychosis
no impairment in functioning
not as severe as mania

30
Q

Cyclothymic Disorder

A

Periods of hypomanic symptoms that fluctuate with
periods of depressive symptoms for 2+ years

never meets criteria for MDE’s or manic

similar to bipolar I, but mood shift are not as extreme

31
Q

etiology and neurobiology of bipolar

A

social or physical stress can trigger mood swing
coping mechanisms can help

manic episodes = more dopamine

32
Q

Bipolar I treatment

A

mood stabilizers

lithium
valproate (anti-convulsion)
olanzapine (antipsychotic)

side effects: hand tremor, polyuria, polydipsia

33
Q

Bipolar II and cyclothymic disorder treatment

A

mood stabilizers - focus more on depression

lithium and valproate

Lurasidone - can be used for bipolar depression (antipsychotic)

motor disturbance side effect

NB3 (last of MS1) (11 decks)

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