Mood 5

Question 1

What are the (6) main risk factors for Premenstrual Dysphoric Disorder (PMDD)?

Answer 1

1. Prior mood episode
2. Increasing age
3. Lack of exercise
4. Stress
5. Diet low in Calcium, Magnesium and B6
6. Family hx of PMDD

Question 2

What is the diagnostic criteria for Disruptive Mood Dysregulation Disorder (DMDD)?

Answer 2

1. Severe and recurrent temper tantrums - grossly out of proportion to provocation. 3 or more times a week.
2. In between tantrums have continuous irritability and anger.
3. Symptoms duration for 12 months and present in at least 2-3 settings.
4. Age of onset before 10 years old. Can’t diagnose before age of 6 years old or after 18 years old.

(Can’t diagnose with ODD, if meets criteria for DMDD, it is an exclusion criteria for ODD).

Question 3

What 7 medications are known to cause depression as SE?

Answer 3

1. Anabolic Steroids
2. ACE Is
3. BB
4. Corticosteroids
5. Interferon-alpha
6. Isotretinoin
7. Reserpine (anti-HTN)

Question 4

What is the concordance rate of MDD in monozygotic vs Dizygotic twins?

Answer 4

50% in monozygotic (same concordance as schizophrenia)

20% in Dizygotic

Question 5

What do adoption studies show in concordance of depression between child and adoptive vs biological parents?

Answer 5

There is higher concordance of depression between biological parents and adopted child when compared to adoptive parent…suggesting certain heritability of depression.

Question 6

What Monoamine NT changes in CSF have been studied in individuals who died via suicide?

Answer 6

Low Serotonin and Low Serotonin metabolite 5-HIAA.

Question 7

What happens when you administer Dexamethasone suppression test to a depressed individual?

Answer 7

You don’t see suppression in 50% of this with MDD and 80% of those with MDD + psychosis.

Suggesting hypercortisol state.

Question 8

What is the relationship with thyroid axis and depression?

Answer 8

1. 5-10% of depressed individuals have abnormal thyroid function.
2. 1/4 of depressed patients have a blunted response to TRH challenge.
3. T3 is an effective augmentation strategy (STAR D)

Question 9

What the the effect of Antidepressants on REM?

Answer 9

Suppression of REM sleep

In depression you see decreased REM latency and increased REM density

Question 10

In chronic depression what areas of the brain can decrease in volume?

Answer 10

HIPPOCAMPUS and CAUDATE NUCLEUS