Mood Disorders Flashcards
What is the definition of Major Depressive Disorder (MDD)?
MDD is a condition where at least 2 weeks of low mood predominate, resulting in significant distress or impairment in functioning.
What is the prevalence of Major Depressive Disorder in the population?
5% of the population.
What is the gender ratio for Major Depressive Disorder?
The ratio of females to males is 2:1.
List the main symptoms required for a diagnosis of MDD.
Depressed mood most of the day nearly every day, Sleep disorder, Interest deficit, Guilt, worthlessness, hopelessness, Energy deficit, Concentration deficit, Appetite disorder (increase or decrease), Psychomotor retardation/agitation, Suicidality or recurrent thoughts of death.
What screening tools are used for diagnosing MDD?
K10, psychiatric interview, and mental status examination (MSE).
What are some common comorbidities associated with MDD?
Other psychiatric disorders, neurological disorders, endocrine disorders, metabolic disorders, and substance misuse.
What is the definition of Dysthymia?
Symptoms of depression lasting at least 2 years, less severe than MDD.
What is the prevalence of Dysthymia in the population?
1%.
What are the diagnostic criteria for Dysthymia?
Depressed mood for most of the day, more days than not for more than 2 years, plus two or more of the following: appetite disorder, concentration deficit, hopelessness, energy deficit, worthlessness, and sleep disorder.
What are some specifiers for Dysthymia?
Mixed features, melancholic features, atypical features, psychotic features, catatonia, peripartum onset, and seasonal pattern.
What are first-line treatments for Dysthymia?
SSRIs such as Sertraline, Citalopram, Escitalopram, Paroxetine, and Fluoxetine.
What characterizes Melancholic Depression?
Persistent and severe depression with a loss of pleasure in all or almost all activities and a lack of reactivity to usual pleasurable stimuli.
What are the symptoms of Melancholic Depression?
Profound despondency, despair, depression worse in the morning, early-morning awakening, marked psychomotor agitation, significant anorexia or weight loss, and excessive or inappropriate guilt.
How is Melancholic Depression typically treated?
Treatment is similar to MDD, with SNRIs being more efficacious.
What distinguishes Atypical Depression from MDD or Dysthymia?
Improvement in mood in response to positive events.
What is the gender ratio for Atypical Depression?
The ratio of females to males is 3:1.
What is the definition of Postpartum Depression?
Low mood and depressive symptoms in the postpartum period, 4 weeks post-birth.
What is the prevalence of Postpartum Depression?
3-6%.
What are the symptoms of Postpartum Depression?
Sadness, worry, empty mood, labile mood, frustration, irritability, anger, guilt, shame, worthlessness, hopelessness, low energy, fatigue, changes in sleep or appetite, decreased concentration, fear of not taking care of the baby, and infanticidal thoughts.
What screening tool is used for Postpartum Depression?
Edinburgh Postnatal Depression Scale.
What are some risk factors for Postpartum Depression?
Prenatal anxiety or depression, personal or family history of depression or postnatal depression, birth-related psychological or physical trauma, poor marital relationship or being single, low socioeconomic status, and unwanted/unplanned pregnancy.
What is the definition of Premenstrual Dysphoric Disorder (PMDD)?
Symptoms of mood lability, irritability, and anxiety that occur repeatedly around the onset of menses and then decrease or dissipate.
What are the diagnostic criteria for PMDD?
In the majority of menstrual cycles, at least 5 symptoms are present in the week before the onset of menses, improving a few days after the onset of menses and becoming minimal or absent in the week post-menses.
List some symptoms of PMDD.
Marked lability (mood swings), marked irritability or anger, marked depressed mood, marked anxiety or tension, decreased interest in usual activities, difficulty concentrating, appetite change, sleep disturbances, sense of being overwhelmed or out of control, and physical symptoms such as breast tenderness, joint pain, bloating, and weight gain.
Define: Mania
A distinct period of abnormally elevated & persistently elevated, expansive or irritable mood
Define: Hypomania
Same features as Mania but does not inflict the same amount of impairment
Distinct period of abnormally elevated, expansive or irritable mood
Classification of Mania?
- Abnormally persistently elevated or irritable mood & increased goal-directed activity or energy. Lasting at least 1week, nearly every day
AND
- A total of three of the “DIGFAST” symptoms must also be present
What does the mnemonic “DIGFAST” stand for?
Distractibility
Indiscretion (engagement in activities potential for harm)
Grandiosity
Flight of Ideas
Activity Increase
Sleep Deficit (↓ need for sleep)
Talkativeness (pressured speech)
Classification of Hypomania?
At least 4 consecutive days of “DIGFAST” symtpoms
Episode is not severe enough to cause marked impairment in functioning
Define: Bipolar I
At least one manic episode, with or without depressive episodes
(Used to be known as Manic Depressive Illness)
Classification for Bipolar Affective disorder (Bipolar I)
Criteria met for at least 1 Manic Episode.
May be preceded by or followed by Hypomania or Major Depressive Episodes
Definition: Bipolar II
Hypomanic and depressive episodes
Classification of Bipolar Affective Disorder: (Bipolar II)
Criteria for current or past Hypomanic Episode
plus
Criteria for Major Depressive Episode
Risk factors for Bipolar II Disorder? (5)
Genetics
Hyperthyroidism
Brain tumour
Cerebrovascular disease
Drugs (PKD, corticosteroids)
Treatment for Acute Mania?
- Hospitalisation – safety of self or others
- First Line:
- Mood Stabilisers – Lithium #1 – takes 7-14 days
- Atypical Antipsychotics – faster onset - Olanzapine, Quetiapine, Lorazedone- approved - Second Line:
Other Mood stabilisers or Antipsychotics
Treatment prophylaxis for Bipolar II disorder?
Mood Stabilisers
1. First Line
Lithium #1
Sodium Valproate, Lamotrigine
2. Second Line
Antipsychotics
3. Third Line
Mood Stabiliser + Atypical Antipsychotic
4. Treatment Refractory
Clozapine
ECT + Mood Stabilisers & Antipsychotics
