Mood Disorders Flashcards by Fathima Mohamed

what makes sadness a mood disordr?

Interferes with everyday life/tasks
Duration
Chemical imbalance

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what is the Epidemiology of Major Depressive Disorder?

Lifetime 16.2%
Prior 12 months, 6.6%
Mean duration 16 weeks
Cormorbid (other disorder) lifetime (72%), 12 month (79%)

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what did the DSM5 split mood disorders into?

depressive disorders and bipolar/related disorders

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what are examples of depressive disorders?

Disruptive Mood Dysregulation Disorder
Major depressive disorder
Persistent Depressive Disorder
Premenstrual Dysphoric Disorder
Substance/Medication – Induced
Depressive Disorder Due to Another Condition
Specified/Unspecified Depressive Disorder

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what are examples of bipolar/related disorders?

Bipolar I
Bipolar II
Cyclothymic Disorder
Substance / Medication-Induced Bipolar
Bipolar/Related Disorder Due to Another Condition.
Other Specified/Unspecified Bipolar and Related Disorder

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what are the core features of bipolar 1 disorder?

Defined by presence of at least one manic or mixed episode, not accounted for by a psychosis disorder

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what are the core features of bipolar 2 disorder?

Defined by presence of at least one manic or mixed episode, not accounted for by a psychosis disorder
has hypomania and no psychotic sy’s

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what are the core features of cyclothymic disorder?

Fluctuating hypomanic symptoms and depressive symptoms

2 years of hypomanic and depressive sx, but not MDD (1 year in children)

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what are the common features of mood disorders>

Sad, Empty, Irritable Mood
With: Somatic and Cognitive Change 
Inability to sleep/sleeping to much
Weight gain/loss
Inability to concentrate
Memory loss

Affects the persons capacity to function.
Social, familial relationships

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what is anhedonia?

Loss of interest or pleasure

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what is the criteria for major depressive disorder?

*Depressed mood
*anhedonia
Weight loss/gain
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue
Feelings of worthlessness or guilt
inability to think or concentrate, indecisiveness
thoughts of death (including suicidal ideation)

5 or more for 2 weeks

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other criteria for major depressive disorder?

B. Clinically significant distress or impaired functioning
C. Not due to physiological effects of a substance or a general medical condition (i.e. hypothyroidism)
D. Not better explained by another disorder.
E. No history of manic episode or hypomanic episode

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what is the severity classification for major depressive disorder?

Mild: 2-3 minimum symptoms
Moderate: in between
Severe: 7-8 symptoms creating severe impairment
With Psychotic Features
In partial Remission:
In Full Remission
Unspecified

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what are the types of course for major depressive disorder?

single episode

recurrent episode

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what is Dysthymia Disorder & Chronic MDD now called?

persistent depressive disorder

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what is persistent depressive disorder?

Persistently depressed mood that lasts for at least 2 years for adults and 1 year for children.
Mean age of onset is early 20’s
Often leads to MDD (~70%)

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what is the difference between MDD and persistent depressive disorder?

symptoms are milder and remain relatively unchanged over longer periods of time
less symptoms required

criteria for persistent depressive disorder?

Poor appetite/over eating
Insomnia/hypersomnia
Low energy/fatigue
Low Self-Esteem
Poor Concentration/ difficulty making decisions
Hopelessness

2 or more symptoms

other criteria for persistent depressive disorder?

No relief for 2 months
(Unless symptoms were severe)
No Manic episode
Not exclusively during psychotic episodes
Not due to substance or medical condition
Clinical impairment

what is unspecified depressive disorder? what are examples?

Depressive disorder that does not meet criteria for another depressive disorder

i.e. Recurrent Brief Depression, Short-Duration Depressive Episode

what are depressions co-morbid disorders?

Anxiety Disorders
Alcohol/Substance Use Disorder
Obsessive-Compulsive Disorder (OCD)
Panic Disorder
Anorexia/Bulimia Disorders
Borderline Personality Disorder

what is the psychological etiology of depression?

Psychodynamic: Unresolved Conflict
Cognitive: negative cognitive triad: self, environment, future
negative schemata
cognitive distortions
Learned helplessness:depression = inability to help yourself

what is the biological etiology of depression?

Being directly related to someone with major depressive disorder makes more likely you will get disorder

Neurotransmitter Deficiencies Hypothesis - NE, dopamine, and serotonin.

what are the EEG findings for depression?

higher alpha readings in left front region

what are depressions affects on sleep?

Sleep disturbances – decrease in slow wave sleep and earlier onset of REM

what do MRI and PET studies show?

increased ventricle size and decreased activity in left lateral prefrontal cortex

what are the psychological tx's of depression?

Depression often improves without treatment Cognitive therapy Behavioral strategies Interpersonal therapy

what are the medicinal tx's of depression?

Antidepressant therapy – MAOs, tricyclics, (SSRIs) Combining pharmacotherapy and psychological therapy Electroconvulsive Therapy (ECT) – (controversial shock tx)

what is a manic episode?

Elevated, expansive or irritable mood- persists 1 wk

what is the criteria for a manic episode?

1. Inflated self esteem, grandiosity 2. Decreased need for sleep 3. Pressure to keep talking 4. Flight of ideas 5. Distractibility 6. Increase in goal directed activity or psychomotor agitation 7. Excessive involvement in pleasurable activities with harmful consequences (Impaired judgment) 8. severe impairment 3 or more

what is the prevalence of psychosis in bipolar disorder?

Psychosis > in mania than depression | Stabilized bipolar patients with history of psychotic features have relapse rates 2-3 times greater than those without

what is hypomania?

Euphoric or irritable mood- at least 4 days –

what is the criteria of hypomania?

same as manic episode but without severe impairment

what are bipolar disorders comorbidities?

Anxiety | Alcohol/Substance Use disorder

what is bipolar disorder misdiagnosed with in children?

schizophrenia, ODD, conduct disorder comorbid with ADHD

what are the characteristics of bipolar disorder in adolescence?

``` Onset after 7 Goal-directed overactivity Episodic Impulsivity from pursuit of pleasure Grandiosity Belligerence ```

what are medicinal tx's of bipolar disorder?

Lithium Anticonvulsants Atypical antipsychotics

what medical conditions cause mood disorders?

Parkinson’s, Huntington’s, stroke, vitamin deficiency, endocrine disorder, autoimmune, viral, cancer

what are substance induced mood disorders?

Depression or mania sx Within a month of intoxication or withdrawal Not exclusively during delirium Clinical distress/impairment Specifiers: depressive, manic, or mixed features, During intoxication or withdrawal

what is seasonal affective disorder?

Onset at a certain time of year Full remission during certain time of year Two MDD episode with a temporal relationship over last 2 years More seasonal depressive episodes than nonseasonal episodes

who get seasonal affective disorder?

Sex: 75% woman | Mean age 40 y/o

what is peripartum depression?

Major Depression onset during pregnancy or within 4 weeks following delivery Due to Chemical imbalance during/after pregnancy