Mood Disorders Flashcards
a sustained emotional attitude; typically garnered through patient self-report
mood
external display of feelings; relates more to others’ perception of the patient’s emotional state
affect
emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months; the event is not traumatic or life-threatening.
The distress is out of proportion with expected reactions.
adjustment disorder
when should the symptoms of adjustment disorder subside, once the stress is removed?
within 6 months
a patient presents with maladaptive symptoms like drug/alcohol use, abnormal behavior, and symptoms of major depressive disorder. what are they likley experiencing?
adjustment disorder
what are 3 risk factors for adjustment disorder?
stressful childhood experiences
hx of mood/eating disorder
family disruptions
what is the treatment for adjustment disorder? (2)
therapy
antidepressants (SSRI, SNRI)
what is the time line of symptoms to be diagnosed with major depressive disorder?
5 or more symptoms during the same 2-week period
at leads one of them being either depressed mood OR loss of interest or pleasure
a patient presents with fatigue, headaches, not sleeping well, lack of interest in usual activities, inability to concentrate, feeling guilt, and loss of appetite with weight loss. what are they likely experiencing?
major depressive disorder
what is the mnemonic for depression assessment?
Sleep disturbance
Interest decrease
Guilt
Energy decrease
Concentration decrease
Appetite (up or down)
Psychomotor function decrease
Suicidal ideations
what are 2 diagnostic studies used to rule out organic contributors of major depressive disorders?
labs
sleep study
what are the 2 treatments for major depressive disorder?
psychotherapy
antidepressant - SSRI
what was the initital treatment in the STAR D trial for major depressive disorder?
citalopram
what is associated with higher rates of relapse + shorter average time to relapse in major depressive disorder?
more treatment steps
patients with major depressive disorder + higher markers of inflammation and obesity are more likely to response to _____ or _____
SNRI
bupropion
patients with major depressive disorder + comorbid pain or migraines are more likely to response to _____ or _____
duloxetine
venlafaxine
how long does an adult patient have to present with depressed mood for most of the day, to be diagnosed with persistent depressive disorder?
2 years
how long does a child patient have to present with depressed/irritable mood for most of the day, to be diagnosed with persistent depressive disorder?
1 year
what is persistent depressive disorder also known as?
dysthymia
an adult patient presents with more depressed days, chronic fatigue, ongoing low mood, rarely feeling pleasure or enjoyment, and is chronically socially avoidant. what is she likely experiencing?
persistent depressive disorder
what is the treatment for persistent depressive disorder?
SAME AS MDD
psychotherapy
antidepressant - SSRI
occurrence of 1 or more manic or mixed episodes - distinct period of abnormally and persistently elevated, expansive, or irritable mood, and increased goal-directed activity or energy lasting over 1 week
bipolar I disorder
never had a full manic episode; at least 1 hypomanic episode and major depressive episode - distinct period of abnormally and persistently elevated, expansive, or irritable mood, and increased goal-directed activity or energy lasting 4-7 days; not severe enough to cause marked impairment.
bipolar II disorder
characterized by 2 years of fluctuating mood (1 year in children) - hypomanic and dysthymic symptoms - no more than 2 months symptom-free
cyclothymia
what is the mnemonic for primary symptoms of a manic attack?
Distractibility
Indiscretion
Grandiosity
Flight of ideas
Activity increase
Sleep deficit
Talkativeness
what are 3 medications for bipolar II depression?
lithium
quetiapine
lumateperone
what is the gold standard treatment for bipolar disorders?
lithium
within the last 24 months, the individual has made a suicide attempt - self-inflicted behavior done in the expectation that it will lead to death
suicidal behavior disorder
deliberate self-inflicted bodily damage with the expectation that the injury will not be lethal, but will lead to mild physical harm
non-suicidal self injury
what are the 5 steps to SAFE-T (Suicide Assessment Five-step Evaluation and Triage)
- identify risk factors
- identify protective factors
- conduct suicide inquiry
- determine risk level/intervention
- document
what assessment is used to determine risk factor of suicidal behavior?
SAD PERSONS
Sex
Age
Depression
Previous suicide attempts/Psychiatric hospitalization
Excessive alcohol or drug use
Rational thinking loss
Single
Organized suicidal attempt
No social support
Stated future intent
what does a patient who scores <6 on the sad persons assessment require?
outpatient management
what does a patient who scores 6-9 on the sad persons assessment require?
emergency psychiatric evaluation
what does a patient who scores >9 on the sad persons assessment require?
inpatient evaluation
what are 2 treatments for suicidal behavior?
CBT
SSRI
what is a predictor of poor treatment response?
hopelessness at intake
