Mood and Anxiety Disorders Flashcards
Define bipolar I disorder.
1+ manic episode with occasional major depressive episodes.
What is the greatest risk factor for developing bipolar I disorder?
family history
Define mania.
abnormal and persistently elevated, expansive, or irritable mood for 1+ week with impairment in social or occupational function.
Describe the characteristics associated with mania and state how many must be present for a diagnosis.
Must have at least 3 of the following:
Mood: euphoria, irritable, labile, dysphoric
Thinking: racing, disorganized, expansive, grandiose
Behavior: hyperactivity, pressured speech, decreased need for sleep, risk taking/impulsivity, increased goal directed activity.
At what age is screening for bipolar I disorder recommended?
12 - 18
What are the treatment options for bipolar I disorder?
- Mood stabilizer: Li, anti-psychotic, valproate
- Improve sleep hygiene
- CBT, behavioral therapy, interpersonal therapy
List three drugs used for bipolar disorder that have significant associated concerns and state those concerns.
Lithium: requires blood level monitoring
Depakote: requires blood level monitoring
Lamortigine: requires adherent patient - sudden withdrawal can cause Stevens-Johnson Syndrome
Define bipolar II disorder.
Hypomania with major depressive episodes
Define hypomania.
Period of elevated, expansive, or irritable mood 4+ days that is different from the patient’s usual non-depressed mood but with no marked impairment.
Describe the characteristics associated with hypomania and state how many must be present for a diagnosis.
Must have at least 3 of the following:
Mood: euphoria
Thinking: racing, disorganized, expansive, grandiose
Behavior: hyperactivity, pressured speech, decreased sleep need, excessive involvement in pleasure activities
Describe the characteristics associated with hypomania and state how many must be present for a diagnosis.
Must have at least 3 of the following:
Mood: euphoria
Thinking: racing, disorganized, expansive, grandiose
Behavior: hyperactivity, pressured speech, dec sleep need, excessive involvement in pleasure activities
Describe the characteristics associated with hypomania and state how many must be present for a diagnosis.
Must have at least 3 of the following:
Mood: euphoria
Thinking: racing, disorganized, expansive, grandiose
Behavior: hyperactivity, pressured speech, dec sleep need, excessive involvement in pleasure activities
What method is used to screen for bipolar I or II?
Mood disorder questionaire.
What are the treatment options for bipolar I disorder?
- Mood stabilizer: Li, anti-psychotic, valproate - carbamazepine for depressive episode
- Improve sleep hygiene
- CBT, behavioral therapy, interpersonal therapy
What are the treatment options for bipolar I disorder?
- Mood stabilizer: Li, anti-psychotic, valproate - carbamazepine for depressive episode
- Improve sleep hygiene
- CBT, behavioral therapy, interpersonal therapy
What must be present for a diagnosis of major depressive disorder to be made?
Depressed mood most of the day and/or loss of interest/pleasure in most activities nearly every day for at least two weeks
What screening tool for depression is commonly used in primary care?
Beck Depression Inventory for Primary Care
In patients successfully treated for depression, what is the greatest risk factor for recurrence and when is recurrence most likely to occur?
R/F: childhood maltreatment
Risk greatest within first few months after treatment
Describe the SIGE CAPS mnemonic used to illustrate symptoms of depression.
S: Sleep changes I: lack of Interest G: excessive Guilt E: lack of Energy C: decrease in Concentration A: altered Appetite P: Psychomotor dysfunction (agitation) S: Suicidal thoughts
What is the risk of suicide in depression patients treated with psychotherapy alone and what age group is at greatest risk?
15% commit suicide –> Males 25-30 and Females 40-50 are at greatest risk.
What is the risk of suicide in depression patients treated with psychotherapy alone and what age group is at greatest risk?
15% commit suicide –> Males 25-30 and Females 40-50 are at greatest risk.
Describe the SADPERSONS mnemonic that illustrates patients at increased risk of suicide.
S: male Sex A: Age (> 85 highest rate) D: Depression P: Previous attempt E: Excess alcohol or other SUD R: lack of Rational thinking S: lack of Social support O: Organized plan N: No spouse S: Sickness (psych or medical)