Mood Disorders Flashcards
What are the 2 primary or marked symptoms of depression?
Depressed mood
Markedly diminished interest or pleasure in activities
Persistent Depression is depression lasting for more than __________
2 years
Double depression is having ___________ + episode of ___________
Persistent depression + major depression episode
A patient has a depressive disorder when the depression affects his or her _________________
Activities of daily living
Depression is diagnosed if depression symptoms lasts for at least _ weeks
2 weeks
Monoamine hypothesis as one of the biological causes of depression refers to the abnormality in the monoamine neurotransmitters like:
norepinephrine, dopamine, serotonin
The neuroendocrine dysregulation in the biological etiology of depression is about patients having (underactive/overactive) HPA, where depressed patients have (hypo/hypercortisolemia)
As a result, they have (increased/decreased) inhibitory serotonin tone, (increased/decreased) drive from norepinephrine, ACh or CRH; or (increased/decreased) feedback inhibition from the hippocampus
Overactive
Hypercortisolemia
Decreased
Increased
Decreased
Depressive disorders are associated with (increased/decreased) lymphocyte proliferations in response to mitogens
Decreased
T/F: Stress from first depression can cause decrease in size and functioning of some parts of the brain
T
Classic presentation of a depressed patient:
Person with:
stooped posture
Decreased movement
Downward averted gaze
T/F: Lack of the classic presentations of a depressed patient implies that a patient has no disorder
F
does not imply
Some of the neurovegetative symptoms of depression include: insomnia, (early/late) morning awakening, worse depression in the (AM/PM)
Early morning awakening
Worse depression in the AM
Features of Major depressive disorder
- Reflects severe disease and a poor prognosticating factor
- Severe anhedonia; associated with changes in ANS and endocrine functions
- Reverse of the neurovegetative symptoms
- Stupor, extreme withdrawal, blunted affect, marked psychomotor retardation as hallmark symptoms
- Onset of symptoms within 4 weeks postpartum
- Depressive episodes occurring during a particular season
a. Postpartum
b. Atypical
c. Seasonal
d. Melancholic
e. Catatonic
f. Psychotic
- Psychotic
- Melancholic
- Atypical
- Catatonic
- Postpartum
- Seasonal
Diagnosis of Major depressive episode includes having __ or more symptoms present on the same __ week period, with at least one of the symptoms being ___ or ___
5
2 week period
depressed mood or lost of interest/pleasure
What are the goals of pharmacological treatment of depression?
- Reduce and ultimately remove all signs and symptoms of the depressive disorder
-Revive the ability to fulfill one’s responsibilities
-Reduce the risk of recurrence of symptoms
Dysthymia is the presence of depressive symptoms that are (more/less) severe than those of major depressive disorder
less severe
This acute treatment for depression is a mood stabilizer
Used to augment standard antidepressant response in acute major depression in those who have had inadequate response to therapy
Lithium
Imipramine, Trimipamine, and Clomipramine are examples of:
a. Tricyclic antidepressants
b. Monoamine oxidase inhibitors (MAOIs)
c. Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
d. Selective Serotonin Reuptake Inhibitors (SSRIs)
a. Tricyclic Antidepressants
fluoxetine, citalopram, escitalopram, paroxetine, sertraline are examples of:
a. Tricyclic antidepressants
b. Monoamine oxidase inhibitors (MAOIs)
c. Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
d. Selective Serotonin Reuptake Inhibitors (SSRIs)
d. Selective Serotonin Reuptake Inhibitor
Phenelizine, Tranylcypromine, seligine are examples of:
a. Tricyclic antidepressants
b. Monoamine oxidase inhibitors (MAOIs)
c. Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
d. Selective Serotonin Reuptake Inhibitors (SSRIs)
b. MAOIs
Duloxetine, venlafaxine, and levomilnacipran are examples of:
a. Tricyclic antidepressants
b. Monoamine oxidase inhibitors (MAOIs)
c. Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
d. Selective Serotonin Reuptake Inhibitors (SSRIs)
c. SNRIs
T/F: All available antidepressants are equally effective.
T
Tricyclics and tetracyclics are (most/least) lethal when taken in overdoses, (most/least) safe cardiac wise, (increased/decreased) risk for hypotension
Dosage is __ mg, _x a day
Most lethal
Least safe
Increased risk
Dosage- 25 mg, 3x a day
True improvement occurs after ________ of treatment
2-4 weeks
T/F: If the patient is still not doing well after 2 weeks, increasing dosage is unnecessary
T
This SSRI has most consistently demonstrated effectiveness in reducing symptoms of depressive disorder in both children and adolescents
Fluoxetine
T/F: TCAs are the reasonable alternatives for persons who cannot tolerate adverse effects of the SSRI
T
T/F: MAOIs are mainly for use in treatment resistant case
T
Central features of mania
Overactivity
Elevated or irritable mood
Self-important ideas
Bipolar I disorder can be preceded or maybe followed by __________
hypomaniac or major depressive episodes
Criteria for manic episode: __ or more of the symptoms for at least _____
3 or more
1 week
T/F: at least 1 lifetime manic episode is required for diagnosis of BD1
T
T/F: An episode of mania is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic
F
Hypomanic
T/F: Hypomanic episodes are not required for the diagnosis of BD1
T
Requirements of bipolar II disorder
at least 1 major depressive episode
at least 1 hypomanic episode
NO history of mania
Cyclothymic disorder is given to adults who experience at least __ years of both _______ and _______ without fulfilling criteria for other disorders
In children and adolescents, only __ year of symptoms is needed for diagnosis
2 years
hypomanic and depressive episodes
1 year for children and adolescents
T/F Symptoms of cyclothymic disorder must be present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time
T
Mean age onset of bipolar disorders
T/F: prevalence in men and women is the same
ave length of a manic episode
T/F: older age, more episodes, less interval
21 yo
T
6 months
T
All second generation antipsychotics except ______ can be used to treat symptoms of acute mania
Clozapine
T/F: ___ and ____ supplemented with benzodiazepines may suffice in treating milder cases of bipolar disorder
lithium and valproic acid
