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Medicine II: Psychiatry > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

What is mood?

A

description of one’s internal emotional state

Sad, happy, angry, etc.

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2
Q

Mood disorders are also know as ______________ and cause________________.

A

Affective disorders, cause:
Abnormal range of moods
Cause distress and impairment in functioning

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3
Q

What are the criteria for a major depressive episode?

A 
D – DEPRESSED mood
S – SLEEP
I  – INTEREST or pleasure
G – GUILT or worthlessness
E – ENERGY or fatigue
C – CONCENTRATION or indecisiveness
A – APPETITE
P – PSYCHOMOTOR
S – SUICIDE ideation or attempt
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4
Q

What are the criteria for a manic depressive episode?

A

Period of abnormally and persistently elevated, expansive, or irritable mood:
D - Distractibility
I - Indiscretion/involvement in pleasurable activities
G - Grandiosity or inflated self-esteem
F - FOI, subjective racing thoughts
A - Activity increase or psychomotor agitation
S - Sleep deficit
T - Talkativeness, pressured

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5
Q

What is the criteria for a hypomanic episode?

A

Persistently elevated, expansive, or irritable mood
Lasting at least 4 days
3 symptoms from manic criteria (or 4 if mood is irritable)

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6
Q

How does a hypomanic episode vary from an manic episode?

A

lasts at least 4 days (not 7)
NO impairment in function
NO hospitalization
NO psychotic features

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7
Q

What are the criteria for a Major depressive disorder?

A

at least one major depressive episode a/w loss of intrest in daily activities
no hx of mania or hypomania

high recurrence rate

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8
Q

How is depression related to suicide?

A

2/3 contemplate

10-15% succeed

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9
Q

What is the treatment for MDD?

A

SSRI, TCA, ECT

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10
Q

What are the criteria for Bipolar 1 Disorder?

A

one manic or mixed episode

typically involves episodes of mania and major depression

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11
Q

What are the criteria for Bipolar 2 Disorder?

A

hypomania and major depression

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12
Q

What is rapid cycling?

A

4 or more mood episodes in a year

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13
Q

What is the most pervasive symptom of bipolar 1 disorder?

A

depression

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14
Q

Is bipolar 1 male or female dominant?

A

its equal

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15
Q

What does bipolar 1 disorder usually start with?

A

depression

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16
Q

What is bipolar disorder linked with in terms of psychiatric disorders?

A

substance abuse and anxiety disorders

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17
Q

How do people with bipolar disorder function in society?

A

excellent academic achievement
numerous jobs
high rates of divorce
chaotic life histories

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18
Q

What is dysthymic disorder?

A

chronic mild depression lasts for atleast 2 years
SYMPTOMS PRESENT MORE DAYS THAN NOT
not symptom free for more than 2 mo,

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19
Q

How does dysthymic disorder differ from MDD?

A

no major depressive episodes

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20
Q

How do we treat dysthymic disorder?

A

therapy and antidepressants

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21
Q

What is the criteria for an adjustment disorder?

A

development of emotional or behavioral symptoms w/in 3 mo of stressful event. The distress is in excess of whats expected

impairment in functioning

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22
Q

When does an adjustment disorder usually resolve?

A

6 mo. after stressor is terminated

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23
Q

What SES has a more common occurance of bipolar disorder? MDD?

A

upper class, non-college grads

equal distribution

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24
Q

What is the life event most associated with the development of MDD?

A

loss of parent before the age of 11

25
Q

How is bipolar disorder different than schizophrenia?

A 
Psychotic features (usually delusions or auditory hallucinations) may be seen in 50% of bipolar patients
During manic/mixed or depressive episodes
Schizophrenics do not experience manic or mixed episodes although they may be depressed or agitated.
Schizophrenics experience psychotic symptoms in the absence of mood symptoms whereas bipolar patients do not.
26
Q

How does seasonality play a role in bipolar episodes?

A

mania more likely in spring/summer

depression in winter/spring

27
Q

T/F: Bipolar disorder patients are aware of their disorder.

A

False they will deny it

28
Q

What is the treatment for bipolar disorder?

A

lithium

29
Q

What is a problem with medication and bipolar disorder?

A

non compliance

30
Q

How long are patients with bipolar disorder on their meds?

A

life, its chronic and recurrent

31
Q

What must we assess for in a patient with bipolar disorder?

A

suicidal or homicidal ideation

32
Q

Do mood disorders have a genetic component?

A

yes and a strong one

33
Q

How do we treat depression?

A

SSRI (fluoxetine, sertraline, paroxetine)

Tricyclic anti-depressants

34
Q

What meds do we avoid with depression? Why?

A

BZD, high potential for abuse

35
Q

What are the primary side effects of SSRIs?

A

GI, headache, sexual, aggitation, sedation

36
Q

What are we worried about with TCAs?

A

lethal in OD

37
Q

How long does an SSRI need to take affect?

A

4-8 weeks

38
Q

What do we do while we wait for SSRI to take affect?

A

tx with BZD but taper off as SSRI comes into effect

39
Q

Should we take patients of anti-depressants abruptly? Why or Why not?

A

No, anti-depressant discontinuation syndrome- dizziness, insomnia, nervousness, nausea, agitation, “zaps”

40
Q

What a treatment for depression that society might not like?

A

ECT
highly effective (80-90% success rate)
no absolute contraindications, requires multiple tx

41
Q

How do we tx acute mania?

A

lithium

42
Q

What type of episode is a psychiatric emergency?

A

manic

43
Q

Are patients with MDD aware of their depression?

A

no

44
Q

What is the gender prevalence of MDD?

A

female > male

45
Q

What are sleep problems a/w MDD?

A

multiple awakenings
insomnia
hypersomnia

46
Q

What MDD tx can have a side effect of a prolonged QTC syndrome?

A

TCA

47
Q

What are the different types of depressive disorders?

A

melancholic
atypical
catatonic
psychotic

48
Q

Describe a melancholic disorder.

A

most common, anhendonia, early morning awakenings, excessive guilt, anorexia

49
Q

Describe a atypical disorder.

A

hypersomnia, hyperphagia, leaden paralysis, and hypersensitivity to interpersonal rejection

50
Q

Describe a catatonic disorder.

A

catelepsy (immobility), purposelessness, motor activity, negativism, mutism, bizarre postures, and echolalia

51
Q

How do we tx catatonic disorders?

A

anti-depressants and psychotics

52
Q

Describe a psychotic disorder.

A

pressence of delusions > hallucinations

53
Q

Can bipolar disorders have psychotic features?

A

Yes, delusions or hallucinations

54
Q

What has a worse prognosis, MDD or Bipolar?

A

Bipolar

55
Q

What is the difference between dysthymic and MDD?

A

MDD is episodic and dysthymic is generally persistent

56
Q

Dysthmic disorder criteria.

A 
C - concentration (poor)
H - hopelessness
A - appetitite, poor
S - insomnia/hypersomnia
E - energy, low
S - self-esteems (low)
57
Q

What is the gender prevalence for dysthymia?

A

women greater than men

58
Q

Can dysthymia have psychotic features?

A

no

59
Q

Treatment for dysthymic disorder.

A

Psychotherapy, SSRI

Medicine II: Psychiatry (11 decks)

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