Mood Disorders Flashcards
Adjustment Disorder
- 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
Major Depressive Disorder
-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
Dysthymia
- 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
Bipolar Disorder I
only requires 1 manic or mixed episode
- typically involves mania and major depression
- most likely comorbid with substance abuse
- 10-15 % commit suicide
Mania
-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
Hypomania
- lasts at least 4 days
- 3 ax’s from manic criteria
- No impairment in fxn, no hospitalization, no psychotic features
Adjustment disorder tx
psychotherapy is best
Dysthymia
-antidepressant (SSRIs, MAOIs), cognitive/behavior/insight-oriented/group therapy
Major Depressant Disorder tx
- 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
Bipolar Disorders tx
- Lithium, Lamotrogine, Quietiapine, Olanzapine/fluoxetine combo, VPA + lithium
- ECT, therapy
- chronic and recurrent tx, must be tailored over lifespan
Acute mania
lithium, valproic acid, atypical antipsychotics, ECT, carbamezapine, clonazepam, lorazepam