Mood disorders Flashcards
What is a depressive episode?
2w
1 core symptom (depressed mood, anhedonia, anergia) + 5 additional symptoms (sleep, guilt/hopelessness, conc, appetite, psychomotor, suicidal/self harm)
What is a manic episode?
7d
Elated mood + 3 symptoms OR irritable mood + 4 symptoms
A/S: distractible, insomnia, grandiosity, flight of ideas, activity/agitation, speech, thoughtless/thought disorder
What is a hypomanic episode?
4d
Elated mood + 3 symptoms OR irritable mood + 4 symptoms
A/S: distractible, insomnia, grandiose, flight of ideas, activity/agitation, speech, thoughtless/thought disorder
What is MDD?
1 depressive episode + x hx of manic/hypomanic episode
What is the epidemiology of MDD?
12% lifetime risk
What is the etiology of MDD?
Genetic
Neurotransmitter abnormality: low monoamines, low 5-HIAA, high cortisol, thyroid
Increased sensitivity of beta receptors
Psychosocial
What are the subtypes of MDD?
Melancholic: early morning awakening, diurnal variation (worse in morning)
Atypical: hypersomnia, hyperphagia, preserved affect
Psychotic
How to manage MDD?
Hospitalization: psychotic, high risk Antidepressant CBT, psychoeducation, IPT Lifestyle: ex, diet, sleep hygiene, avoid alcohol/SA TRD: ECT
What is treatment-resistant depression?
Inadequate response to 1 antidepressant trial of adequate dosage & duration
What is dysthymia?
2y of depressive symptoms, 2m symptom free
What is bipolar disorder?
Bipolar 1: manic episode
Bipolar 2: hypomanic + depressive episode
What are the symptoms of bipolar disorder?
Biological: insomnia, increased energy (goal-directed activities, risky behavior e.g. overspending, unsafe sex)
Cognitive: grandiosity, distractible, accelerated thinking, impaired judgment & insight
Psychotic: thought disorder, delusion, hypersensitivity to perception
How to manage bipolar disorder?
Acute mania: hospitalization, tranquilization (IM haloperidol or lorazepam) stop all antidepressant, increase lithium, give SGA & mood stabilizer
Acute depression: lamotrigine or aripriprazole
Maintenance: mood stabilizer or SGA
What are the indications of hospitalization in bipolar disorder?
Reckless behavior
Psychotic
Excessive psychomotor agitation
Risk to self or others
What is cyclothymia?
Mild depressive & hypomanic symptoms for 2y but x meet criteria for an episode, x symptom free for 2m
