mood disorders

Question 1

1 mania/manic episode lasts for ___ and present ____

Answer 1

about a week; most of the day, nearly everyday

Question 2

1 major depressive episode lasts for ____

Answer 2

at least 2 weeks

Question 3

Clinical features of Major depressive episode

Answer 3

• Depressed mood
• ↓ interest, poor concentration
• Ideas of guilt & worthlessness
• ↓ self esteem
• ↓ energy & activity
• Fatigue, insomnia, hypersomnia
• ↓ libido
• ↓ appetite, weight loss
• Somatic symptoms

Question 4

Clinical features of both bipolar disorders

Answer 4

• Inflated self esteem
• ↓ need of sleep
• More talkative
• Flight of ideas
• Distractibility
• Psychomotor agitation (hypersexual)
• High risk behaviour

Question 5

Just list treatments of major depressive disorder

Answer 5

1. Tricyclic antidepressants (TCAs)
2. Monoamine Oxidase Inhibitors (MAOIs)
3. Selective serotonin reuptake inhibitors (SSRIs)

Question 6

What are the unwanted effects of TCAs?

Answer 6

• sedation
• orthostatic hypotension
• anticholinergic side effects (eg. constipation, urinary retention, dry mouth, blurred vision and, at times, cognitive impairment.)

Question 7

What to avoid when taking MAOIs?

Answer 7

1. Tyramine-rich food
   eg. red wine, cheese
2. Flu meds containing ephedrine, pseudoephedrine, SSRIs

Question 8

What treatment of major depressive disorder is generally better tolerated and safer for elderly?

Answer 8

Selective serotonin reuptake inhibitors (SSRIs)

Question 9

What are the anti-depressants which can produce substantial inhibition of some hepatic cytochrome P450 enzymes and thus higher risk of drug interactions?

Answer 9

SSRIs– Luvox, Prozac and Paxil

Question 10

Just list treatments of bipolar disorder

Answer 10

1. Lithium carbonate
2. Anticonvulsants
3. Atypical antipsychotics

Question 11

What is the most effective treatment for bipolar disorder?

Answer 11

Lithium carbonate

Question 12

Can changes in dietary Na intake affect Li levels?

Answer 12

Yes

Question 13

Therapeutic range of Li

Answer 13

0.4-1.0mmol/L

Question 14

How many hypomanic & manic episode does bipolar II disorder have?

Answer 14

at least 1 hypomanic episode

BUT has NOT had a full manic episode

Question 15

How long are the manic episodes of cyclothymia?

Answer 15

a distinct period of severe mania for at least 1 week with rapid shift of mood

Question 16

*** V IMPT!

List out at least 5 DSM V DIagnostic Criteria

Answer 16

5 or more of the following over 2 weeks:

• 1. depressed mood most of the day, for most days
• 2. diminished interest & pleasure on activities
• 3. significant weigh tloss
• 4. insomnia or hypersomnia
     
     5. psychomotor agitation or retardation
     6. feelings of worthlessness or excessive guilt

Question 17

The difference between manic and hypomanic episodes

Answer 17

Manic episodes:

• Symptoms are severe enough to cause marked impairment in social or occupational functioning + risk to self & others
• Last at least 1 week

Hypomanic episodes:

• Same as manic episodes but symptoms NOT severe enough to cause marked impairment..
• Disturbances in mood are observable by others
• Last at least 4 consecutive days