mood disorders Flashcards

1
Q

what are the five mood disorders?

A
  1. major depressive disorder
  2. bipolar I disorder (manic/mixed episodes)
  3. bipolar II disorder (major depressive and hypomanic episodes)
  4. dysthymia (chronic/less severe unipolar depressive)
  5. cyclothymia (2+ yr between hypomanic and depression)
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2
Q

how do you distinguish between unipolar and bipolar?

A

polarity; is mania present?
cyclicity; goes between two or one
severity; how many symptoms
duration; how long does it last

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3
Q

symptoms of major depression (how many needed)

A

at least one of 1-2, and 5/9 in total
-depressed mood
-loss of interest in activities and/or people
-marked insomnia or hypersomnia
-low energy
-increased or decreased appetite leading to weight gain or loss
-psychomotor retardation or agitation
-feelings of worthlessness or guilt
-poor concentration or indecision
-thoughts of death and/or suicide

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4
Q

what is the duration of depression?

A

symptoms must last 2 weeks at a time (average of 6 months) and cause significant distress or impairment

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5
Q

what is the depression course for MDD single episode and recurrent episode?

A

single episode; 2 weeks long
recurrent; 2 months in between episodes of 2 weeks
-episodes can last 6-9 months on average to years
-50% experience a second episode
-90% experience recurrent episodes after the second

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6
Q

symptoms of persistent depressive disorder

A

-persistently low mood that continues for at least 2 years (don’t go without symptoms for >2 months, +2 additional symptoms
-poor appetite or overeating
-insomnia or hypersomnia
-low energy or fatigue
-low self-esteem
-poor concentration or indecision
-feelings of hopelessness

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7
Q

symptoms of hypomania (how many needed?)

A

A distinct period of persistently abnormally elevated, expansive, or irritable mood, lasting at least 4 days
3 or more of the following symptoms (4 if mood is only irritable)

-inflated self-esteem or grandiosity
-decreased need for sleep
-pressured speech
-flight of ideas
-distractibility
-increase in goal-directed activity or agitation
-excessive involvement in risky activity

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8
Q

symptoms of mania (how many needed?)

A

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and persistently increased goal-directed activity or energy, lasting at least a week
3 or more of the following symptoms (4 if mood is only irritable)

-inflated self-esteem or grandiosity
-decreased need for sleep
-pressured speech
-flight of ideas
-distractibility
-increase in goal-directed activity or agitation
-excessive involvement in risk

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9
Q

what is bipolar I?

A

mania + major depression

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10
Q

what is bipolar II?

A

hypomania + major depression

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11
Q

what is cyclothymia?

A

hypomania + subthreshold depression over 2 year period

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12
Q

what is seasonal affective disorder?

A

occur in both unipolar MDD and bipolar, recurrent depressive episodes tied to seasons changing, 11% of MDD patients, 2-3% prevalence

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13
Q

what is peri- and post-partum mood disorder?

A

peripartum is the last month of gestation of first few months after delivery, postpartum is anytime after delivery/peripartum period, both meet the criteria for major depressive or manic episode

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14
Q

what is premenstrual dysphoric disorder?

A

marked affective lability, irritability/anger, depressed mood, and/or anxiety, plus additional similar to MDD, significant impairment and during most cycles in a year

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15
Q

what are the four cognitive theories/distortions?

A
  1. All or nothing thinking; seeing black-and-white, if you performance falls short of perfect you see yourself as failure
  2. Overgeneralization; seeing a negative event as a never-ending pattern of defeat using words such as always or never
  3. Magnification; exaggerate the importance of errors or problems
  4. Jumping to conclusions; interpret things negatively when there is no definite facts to support your conclusion
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16
Q

what is suicide?

A

the intentional taking of ones own life
-ideation
-gestures
-attempt
-completed attempt
-self harm

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17
Q

what is the diathesis-stress model?

A

diathesis (a predisposition or vulnerability) + a stress (environmental) leads to the development of a disorder (higher diathesis, less stress needed)

18
Q

what are the risk factors for suicide?

A

-male, culture, and age
-15% of depressed people complete a suicide
-70% suffer from major depression
-alcohol and substance abuse
-schizophrenia
-hereditary
-low serotonin levels

19
Q

what is anomic suicide?

A

one’s relationship to society has changed so radically that its values and norms are no longer personally relevant

20
Q

what is egoistic suicide?

A

bonds which unite groups weaken and individuality increases, stemming from the absence of social integration

21
Q

what is altruistic suicide?

A

bonds between groups are too strong, so individuals sacrifice themselves

22
Q

what are the three neurotransmitters?

A

serotonin, norepinephrine, and dopamine

23
Q

what is serotonin’s function? (5-HT)

A

functional disturbances, low activity, fewer receptors, activation and disinhibition of some behaviours

24
Q

what is norepinephrine’s function?

A

excessive happiness and grandiosity

25
Q

what is dopamine’s function?

A

regulation of reward processing and motor behaviour, hyperactivity and psychosis

26
Q

what happens to the brain with depression?

A

amygdala (identifies the significance of emotional stimuli) becomes overactive, smaller volumes, inability to disengage from negative information

27
Q

what happens to the brain with mania?

A

overactive amygdala, diminished activity in hippocampus and prefrontal cortex (goal setting, planning, and inhibition), and basal ganglia is overactive (reward pathway)

28
Q

what is the treatment for mood disorders?

A

-psychological
-pharmacologic
-neurostimulation and neurosurgical

29
Q

what is cognitive-behavioural therapy?

A

challenges negative thinking and the resulting behaviours

30
Q

what is interpersonal therapy?

A

examines interpersonal disputes, role transitions, grief, interpersonal deficits

31
Q

what is the function of tricyclic antidepressants?

A

moa unclear, downregulate norepinephrine and affect serotonin, effects take up to 8 weeks, 50% of patients, 40% discontinue against medical advice, lethal with overdose

32
Q

what is the function of moa inhibitors?

A

inhibits the mechanism that breaks down neurotransmitters (synapse longer), downregulates norepinephrine and serotonin, fewer but more severe side effects

33
Q

what is the function of selective serotonin reuptake inhibitors?

A

block reuptake, primary treatment, effective for 50-70% of people with depression

34
Q

what medications treat bipolar disorder?

A

lithium, anticonvulsants, antipsychotics, and antidepressants (w/ mood stabilizers)

35
Q

what is lithium’s function?

A

mood stabilizing salts, dosage to be monitored carefully, high toxicity, 30-60% good response, 70% relapse

36
Q

what are anticonvusants function?

A

prescribed alone or with lithium/antipsychotic drugs

37
Q

what are antipsychotics function?

A

short-term treatment during an acute manic or depressive episode

38
Q

what are antidepressants function?

A

used to treat the depressive phase in bipolar disorder

39
Q

what is phototherapy?

A

for seasonal affective disorder. Sad; affects patients during time of low light, phase delayed circadian rhythms, phototherapy resets circadian clock by stimulating sun

40
Q

what is neurostimulation and neurosurgical treatment?

A

electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, and deep brain stimulation