Mood Disorders

Question 1

Percent of manic pts have psychotic sxs?

Answer 1

75%

Question 2

What mood state is predominant in mixed episodes?

Answer 2

Irritability

Question 3

Tx for mixed episodes?

Answer 3

Anticonvulsants (lithium not so much)

Question 4

CV dz causing depression?

Answer 4

1) Stroke

2) MI

Question 5

Endocrinopathies causing depression?

Answer 5

1) DM
2) Cushing’s
3) Addison’s
4) Hypoglycemia
5) Hyper/hypothyroidism

Question 6

Mvt disorder causing depression?

Answer 6

Parkinson’s

Question 7

Viral illness causing depression?

Answer 7

Mononucleosis

Question 8

Cancer causing depression?

Answer 8

1) Pancreatic cancer
2) Lymphoma
3) Carcinoid

Question 9

Collagen vascular dz causing depression?

Answer 9

SLE

Question 10

Medical causes of manic episodes?

Answer 10

1) Hyperthyroidism
2) Temporal lobe seizures and MS
3) Neoplasms
4) HIV infection

Question 11

What has the highest rate of suicide of any disorder?

Answer 11

Depression

Question 12

Sleep problems in MDD?

Answer 12

1) Multiple awakenings
2) Initial and terminal insomnia
3) Hypersomnia
4) Decreased REM latency
5) Shorter stages 3 and 4

Question 13

Biological changes causing depression?

Answer 13

1) Low serotonin and 5-HIAA in brain and CSF
2) Abnormal beta-adrenergic receptors
3) High cortisol (failure to suppress cortisol in dex suppression test)
4) Abnormal thyroid axis
5) GABA and endogenous opiate changes

Question 14

How do you assess the effectiveness of therapies for depression?

Answer 14

Hamilton Rating Score

Question 15

Prognosis of depressive episodes?

Answer 15

If left untreated–last 6-13 months

Question 16

Percent of depressed pts commit suicide?

Answer 16

15%

Question 17

Tx for catatonic depression?

Answer 17

Antidepressants + antipsychotics (also ECT)

Question 18

Rapid cycling?

Answer 18

> 4 mood episodes in 1 year

Question 19

Highest genetic link of all major psych disorders?

Answer 19

Bipolar I

Question 20

Prognosis of untreated manic episodes?

Answer 20

3 months

Question 21

Best tx for manic woman in pregnancy?

Answer 21

ECT

Question 22

Good meds for tx rapid cycling bipolar disorder and mixed episodes?

Answer 22

Anticonvulsants (although assoc with increased risk of suicide)

Question 23

What drugs should not be taken for tx bipolar?

Answer 23

Antidepressant monotherapy (activates mania or hypomania)

Question 24

How do you tx a pt with hx of postpartum mania?

Answer 24

Antidepressants + lithium in subsequent pregnancies

Question 25

Double depression?

Answer 25

MDD with dysthymic disorder during residual periods

Question 26

Triad for seasonal affective disorder?

Answer 26

1) Irritability
2) Carbohydrate craving
3) Hypersomnia