Mood Disorders

Question 1

Adjustment Disorder

Answer 1

• development of emotional or behavioral sx’s within 3 months of a stressful event
• Not bereavement
• stressors resolve within 6 months after stressor has been terminated

Question 2

Major Depressive Disorder

Answer 2

-DSIGECAPS
D= depressed mood
S= sleep (insomnia or hypersomnia)
I= interest or pleasure (decrease in all or almost all)
G =guilt
E - Energy or fatigue 
C= concentration or indecisiveness
A= appetite (decreased) 
P= psychomotor agitation or retardation 
S= suicide ideation or attempt

Question 3

Dysthymia

Answer 3

• chronic MILD depression
• sx’s of depression are present for most days x 2 yrs
• NO major depressive disorder
• habitual gloom, brooding, lack of joy and preoccupation with inadequacy

Question 4

Bipolar Disorder I

Answer 4

only requires 1 manic or mixed episode

• typically involves mania and major depression
• most likely comorbid with substance abuse
• 10-15 % commit suicide

Question 5

Mania

Answer 5

-persistently elevated, expansive or irritable mood lasting at least 1 week with 3 sx’s
-DIGFAST:
D=distractibility
I= indiscretion/involvement in pleasurable acitivities
G=grandiosity or inflated self esteem
F= FOT, subjective racing thoughts
A= activity increase or psychomotor agitation
S= sleep deficit
T=talkativeness, pressured

Question 6

Hypomania

Answer 6

• lasts at least 4 days
• 3 ax’s from manic criteria
• No impairment in fxn, no hospitalization, no psychotic features

Question 7

Adjustment disorder tx

Answer 7

psychotherapy is best

Question 8

Dysthymia

Answer 8

-antidepressant (SSRIs, MAOIs), cognitive/behavior/insight-oriented/group therapy

Question 9

Major Depressant Disorder tx

Answer 9

• SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram)
• TCAs (elavil, tofranil, norpamin, sinequan)
• Other (venlafaxine, mirtazapine, buproprion, MAOIs)
• Need adequate trial on given med (6-8 weeks), don’t stop taking w/out consulting m ed professional
• Avoid benzos
• ECT with failure of several meds
• Pyschotherapy

Question 10

Bipolar Disorders tx

Answer 10

• Lithium, Lamotrogine, Quietiapine, Olanzapine/fluoxetine combo, VPA + lithium
• ECT, therapy
• chronic and recurrent tx, must be tailored over lifespan

Question 11

Acute mania

Answer 11

lithium, valproic acid, atypical antipsychotics, ECT, carbamezapine, clonazepam, lorazepam