Mood Disorders Flashcards
Draw a mood vs time curve for biopolar I and II, cyclothymic, persistent depressive, MDD, adjustment disorder
DSM 5 criteria for MDD:
At least ___ of the following 9 symptoms present during a ___ week period, nearly every day, including ONE of the FIRST TWO: (list the 9)
B. Significant ___ or impairment in functioning
C. Not due to direct ___ effects of a substance or a general medical condition
D. Not better explained by another ___ ____
E. NEVER a ___ episode
At least 5 of the following 9 symptoms present during a 2 week period, nearly every day, including ONE of the FIRST TWO:
- depressed mood
- anhedonia
- anergia
- appetite change
- insomnia or hypersomnia
- psychomotor agitation
- feelings of worthlessness or guilt
- poor concentration
- recurrent thoughts of death or suicide
B. Significant distress or impairment in functioning
C. Not due to direct physiological effects of a substance or a general medical condition
D. Not better explained by another mental disorder
E. NEVER a manic episode
T/F there can be a manic period of major depressive disorder
false. a DSM criteria for MDD is that there is NEVER a manic episode
monoamine hypothesis for epidemiology of major depressive disorder
decreased NE and 5HT, evidence from post-mortem studies and antidepressants and PET scan
natrual course of major depressive disorder, courese for treated MDD?
untreated course lasts 13 months, treated episodes last for 3 months.
additional symptoms of MDD
Additional symptoms: loss of libido, diurnal variation of mood (worse on waking), hallucinations, delusion, worse in winter (SAD), onset in pregnancy or month after delivery, pseudodementia
Adjustment Disorder with Depressed Mood:
Definition: depressed mood and other symptoms present but not severe enough for ___ ___, and not long enough for ___ (must resolve in ___ months)
Note: major depression trumps adjustment disorder
Treatment: ___ ____
Adjustment Disorder with Depressed Mood
Definition: depressed mood and other symptoms present but not severe enough for major depression, and not long enough for dysthmuia (must resolve in 6 months)
Note: major depression trumps adjustment disorder
Treatment: supportive psychotherapy
differentiate bereavement vs major depression
bereavement is distinguished by:
- no suicidal ideas
- psychosis not presente (except visual hallucination of deceased)
- guil doesn’t extend beyond deceased
- time scale (less than 2 months in DSM IV, no longer applies in DSM 5)
Definition of mood disorder due to another medical condition
Definition: mood disorder of any severity (including major depression) but “prominent and persistent and directly due to a medical disorder)
Neurological causes: CVA, parkinsons
Viral: mononucleosis, HIV, hepatitis
Endocrine: cushings, hyperparathyroidism, hypothyroidism
Other: cancer, B12 deficiency
Treatment: treat cause first, then antidepressant if needed.
prescription drugs that can cause a substance/medication induced mood disorder
Prescription drugs: corticosteroids (mania), oral contraceptives (depression), antipsychotics
difference between bipolar I and II disorder and cyclothymia
bipolar I: manic episodes and major depressive episodes
biopolar II: hypomanic episodes and major depressive episodes
cyclothymia: 2 years of hypomanic or depressed symptoms without qualifying as a clear mood episode.
T/F males and females equally suffer from bipolar disorder
true. there is an equal sex ratio. eariler onset than unipolar, more episodes than unipolar
definition of a manic episode:
Manic Episode: ___ of abnormally elevated or irritable mood and increase __ or __ __ activity +___ of the 7 symptoms: (DIGFAST)
Manic Episode: 1wk of abnormally elevated or irritable mood and increase energy or goal directed activity +3 of the 7 symptoms:
distractability
indiscretion
grandiostiy
flight of ideas
increased activity/goal directed activity
sleep deficit
talkative/pressured speech
compare and contrast manic episode vs hypomanic episode
Manic Episode: 1wk of abnormally elevated or irritable mood and increase energy or goal directed activity +3 of the 7 symptoms:
- Grandiosity
- Decreased need for sleep
- More talkative than usual, “pressure of speech”
- Flight of ideas
- Distractibility
- Increase in goal directed activity
- Excessive involvement in pleasurable activities (sex, over-spending money
Hypomanic Episode: same list of symptoms as manic episode for 4-7 days, less severe as judged by no marked impairment/psychosis/hospitalization
Antidepressant: All Antidepressants work on the monoamine theory of depression, that there is a reduction in 5HT and NE in synaptic transmission. The drugs act to increase monoamine levels by either blocking transmitter reuptake from the synapse (___ and ___) or by blocking metabolism of the transmitters in the neurone (___).
Antidepressant: All Antidepressants work on the monoamine theory of depression, that there is a reduction in 5HT and NE in synaptic transmission. The drugs act to increase monoamine levels by either blocking transmitter reuptake from the synapse (TCA and SSRI) or by blocking metabolism of the transmitters in the neurone (MAOI).
