Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Behavioral Medicine and Health > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

What disorders is a major depressive episode involved with? With which is it a necessary part of diagnosis?

A 

Isabuildingblock:

Necessaryfordiagnosisof:

MajorDepressiveDisorder(MDD)

BipolarIIdisorder

AlwayspartofBipolarIDisorder

Butnotnecessaryforthediagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the qualifications for a diagnosis of a major depressive episode ?

A 

Fiveormoreofthefollowingsymptomshavebeenpresent,moredaysthat not,forATLEASTa2‐weeks: One of the first two must be present. 

Depressedmood

Diminishedinterestorpleasure

Weightlossorgain

Insomniaorhypersomnia

Psychomotoragitationorretardation(observablebyothers)

Lowenergyorfatigue

Feelingsofworthlessnessorguilt(excessiveorinappropriate/delusional)

Poorconcentrationorindecisiveness

Recurrentthoughtsofdeathorsuicidality


NotaMixedepisode(i.e.nocoexistingmanicsymptoms)

Theepisodemustcausedistressorsocial/occupationalimpairment

Notduetosubstanceuse,medicalcondition,orbereavement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some examples of emotional/cognitive symptoms of MDE? Neurovegetative ones?

A 

MDEcanbecharacterizedbyacombinationof:

Emotonal /cognitivesymptoms,example:

Depressedmood

Anhedonia

Hoplessness

SlowedThinking/PoorAttention(Memory)

Suicidality


Neurovegitative symptoms,example:

Sleep(mostlypoor,butcouldbebidirectional)

Appetite(mostlypoor,butcouldbebidirectional)

Energy(lossof,unidirectional)

Slowedmovements,stoopedpostures,lossofgesturing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is a major depressive disorder diagnosed? What are two types? What is the difference?

A 

AtleastoneMDE

NohistoryofMixedorManicorHypomanic episode

MDD,singleepisode vs recurrenttype

InordertohaverecurrentMDD,theindividualmusthave
twoMDEseparatedbyatleast2months
offullrecovery.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the qualifications for a diagnosis of dythymic disorder? What is double depression?

A


Depressedmood,moredaysthannot,foratleast2year

Children/Adolesents:depressed
OR
irritable moodforatleast1year.

Neversymptom‐freeformorethan2months

Atleast2ormoreassociatedsymptomswhiledepressed:
 Poorappetiteorovereating
 Insomniaorhypersomnia
 Lowenergyorfatigue
 Lowself‐esteem
 Poorconcentrationordifficultymakingdecisions
 Feelingsofhopelessness

NoMDEsduringtheinitial2yearperiod(otherwise–>MDD)

“doubledepression”
ifDysthymic disorderisfollowedbyMDE

NoHistoryofMania,Hypomania,Mixed episodeorCyclothymia

NointhecourseofChronicPsychoticDisorder(Schizophrenia)

Theepisodemustcausedistressorsocial/occupationalimpairment

Notduetoasubstanceuseormedicalcondition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Depressive Disorder NOS? What are some examples?

A


PremenstrualDysphoric Disorder
 Markeddepression/anxiety,Affectivelability,Decreaseinterest
 Mostmenstrualcyclesforthepast12months
 Sx startduringthelastweekoftheluteal phase
 Absentforatleast1weekpostmenses

MinorDepressiveDisorder
 Depressionforatleast2weeks
 Fewerthan5symptomsofMDE

Recurrentbriefdepressivedisorder
 AllsymptomsofMDE
 >2days,but<2weeks
 Atleastoncepermonthoverthelastyear

PostpsychoticdepressivedisorderofSchizophrenia(residual)

MDEsuperimposedonDelusionalDisorder,activephaseofSchizophreniaorPsychosisNOS

Ifcliniciancannotdeterminetheifthedepressionisprimary,duetoGMCorSubstance Induced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the qualifications for a manic episode?

A

Adistinctperiodofabnormallyorpersistentlyelevated,expansive,orirritable mood,lastingatleast1weekwith>3(4ifmoodisirritable)ofthefollowing

Inflatedself‐esteemorgrandiosity

Decreasedneedforsleep

Moretalkativeorpressuredtokeeptalking

Flightofideasorracingthoughts(subjective)

Distractibility

Increasedgoal‐directedactivityorpsychomotoragitation

Excessiveinvolvementinpleasurableactivitiesthathavehighpotentialforpainful consequences(buyingsprees,sexualindiscretion,foolishinvestments)

Ifhospitalizationisnecessary, Anydurationissufficient

Theepisodemustcausedistressorsocial/occupationalimpairment

Notduetoasubstanceuse(includingsomatictx fordepression)ormedical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the criteria for a mixed episode?

A 

Criteriaaremetconcomitantly for:

ManicEpisode

MajorDepressiveEpisode(excepttheduration)

Theepisodemustcausedistressorsocial/occupational
impairment

Notduetoasubstanceuse(includingsomatictx for
depression)ormedicalcondition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the criteria for a hypomanic episode?

A 

Distinctperiodofelevated,expansive,orirritablemood
thatincludesatleast3(4ifmoodisirritable)symptoms
of
includedinthemanicepisode


Atleastfor4days

Unequivocalchangeinfunctioning

Nomarkedimpairmentinsocial/occupationalfunctioning

Nopsychoticfeatures

Doesnotrequirehospitalization

Notduetoasubstanceuse(includingsomatictx for
depression)ormedicalcondition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the criteria for a diagnosis of Bipolar type I

A 

ClassicManic
‐
DepressiveDisorder

Bydefinition,inordertoreceivediagnosisofbipolarIyou
MUSThaveexperiencedatleast
oneManic
or
Mixed
episode

MostindividualswithbipolardisorderhaveseveralMajor
DepressiveEpisodesprecedingtheirfirstManicorMixed
episode

MDEisnotneededforthediagnosis

NotaccountedforbySchizoaffectived/oandnot
superimposedonotherprimarypsychoticdisorders.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the avg. age of onset for bipolar illness? What is they’re over 45? What is the course of illness like compared to MDD? How so? What is the initial episode normally like? What is the gender prevalence like?

A 

Lifetimeprevalence~1
‐
2%

Averageageofonsetforbipolarillness=30y.o.


FirstonsetManicsympomts >age45
1rstthinkorganic etiology

lifecourseofillnessinbipolarIisgenerallyworsethan unipolar depression

Moredysfunctionandlifedisruption

Moreassociationwithsubstanceuse

MoreAttemptedandCompletedsuicides

Initialepisodemostcommonlyadepressiveone

NOsexdifferenceinprevalence(exceptforrapidcycling subtype)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the criteria for Bipolar type II?

A


HistoryofoneormoreMajorDepressiveEpisodesAND at
leastoneHypomanic Episode

NohistoryofpriorManicorMixedMoodepisode

NotaccountedforbySchizoaffectived/oandnot
superimposedotherprimarypsychoticdisorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the criteria for cyclothymia?

A 

Foratleasttwoyears(1yearfor<18y.o.)

IffollowedbyManicepisdoe

Cyclothymia
and
BPDI

IffollowedbyMDE

Cyclothymia
and
?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are 9 types of mood specifiers?

A 

Severity:Mild,ModerateandSevere(MDE,Manicor
Mixedepisodes)

Chronic(MDE>2years)

MelancholicFeatures(MDE)

AtypicalFeatures(MDE&Dysthymia)

CatatonicFeatures(MDE,ManicorMixedepisodes)

PsychoticFeatures(MDE,ManicorMixedepisodes)

Post
‐
partumonset(MDE,ManicorMixedepisode)

Rapidcycling(BipolarIorII)

Seasonalpattern(MDEinMDDinBPI&II)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are melancholic features a specifier for? What are the criteria that need to be met for it? What is an implication for treatment?

A 

OnlyforMDE(MDD,BipolarIorII)

Oneofthefollowing:

Completelossofpleasure

Lackofreactivitytousuallypleasurableactivities

Threeormoreofthefollowing:

Depressionisworseinthemorning

Distinctqualityofdepressedmood

Earlymorningawakening(atleast2hr)

Markedpsychomotorretardationoragitation

Significantanorexiaorweightloss

Excessiveinappropriateguilt

Responds better to ECT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are atypical features a specifier for? What are the criteria that need to be met for it? What is the preferential treatment?

A


CanbeusetodescribeMDEofMDD,BipolarIorII.Italso
canbeusedasaspecifier forDysthymic d/o

Preservedmoodreactivityandtwoormoreof:

Hypersomnia

Hyperphagia

Leadenparalysis

Long‐standingpatternofinterpersonalrejectionsensitivity

MaypreferentiallyrespondtotreatmentwithMAOI’s

17
Q

What are catatonic features a specifier for? When is it most commonly seen? What are the criteria that need to be met for it? What is the preferential treatment?

A


Canbeuseasaspecifier todescribeMDE(inMDDorBP),
ManicorMixedepisode

Twoofthefollowing:

Catalepsy(immobility/waxyflexibility)orStupor

Excessiveandpurposelessactivity

Extremenegativismormutisim

Peculiarityofmovements:posturing,stereotyped
movements,prominentmannerismorgrimacing

MostcommonlyseenwithBipolarDepression

ECT

18
Q

What are psychotic features a specifier for? What are the criteria that need to be met for it? What is the preferential treatment?

A 

Canbeuseasaspecifier todescribeMDE,ManicorMixed episode

Psychotic vs.nonpsychoticdepression
mayrepresentdistinctlydifferentdisordersintheir
pathogenesis

Shouldbedescribedas:

moodcongruent

voicestellingthepersontheyareworthless

moodincongruent

afixedbelievethataliensfromMars….

Moodincongruentpsychoticsymptomscouldsuggestthe possibilityofaprimarypsychoticillness

Areassociatedwithpoorerprognosis

Psychoticsymptomindepressionwarranttreatmentwith BOTHanantidepressantANDanantipsychoticand/orECT
19
Q

What is rapid cycling a specifier for? What are the criteria? What is the preferenctial treatment? Who is it more common in?

A


MusthaveBipolarIorII

Musthaveatleast4separatemoodepisodeswithinthe
previous12months(MDE,Manic,MixedorHypomanic)

DOESNOTappeartoruninfamilies

Valproic AcidandCarbamezapine maybesuperiorin
treatingrapidcycling(lithiumisineffective)

Morecommoninyoungfemales

20
Q

What is seasonal pattern a specifier for? What is it like? What are the criteria? What is a possible treatment? When can it be risky?

A

AppliestotheMDEofRecurrentMDD,bipolarI&II

MDEsatadistincttimeoftheyear(fallandwinter)

Fullremission(ormanic/mixed/hypomanic episodes)
occuratadistincttimeoftheyear(spring)

Patternshouldoccurforatleast2years

CommonlyreferredtoasSAD=SeasonalAffective
Disorder

TheMDEarelikelytorespondtolighttherapy(Riskfor
“Switching”ifBipolard/o)

21
Q

Waht is mood disorder due to a general condition? How should it be treated?

A


Moodsymptomsarebelievedtobethedirect
physiologicalconsequence ofageneralmedicalcondition

History,PhysicalExamand/orLaboratoryfindings

Notanadjustmentd/o(stressofmedicalillness)

NotDelirium

Ingeneralshouldtreatmoodwithpsychotropicand/or
psychotherapyinadditiontotreatingtheprimarymedical
problems(ex,hypothyroidism

22
Q

What is a substance induced mood disorder?

A


Substanceuse(orwithdrawalfrom)musthaveoccurred
withinONEMONTHofthemoodsymptoms

Mooddisorderbelievedtobeetiologicallylinkedtothe
substanceuse

examplesinclude:

Mania:corticosteroids,cocaine,amphetamines

Depression:Beta‐blockers,Reserpine,cocaine[withdrawal]
alcohol)

Thedisturbanceisnotaccountedforbyanongoing
primarymood

Nodelirium

23
Q

What is serotonin made from? What does it dwell in the brain? How is its action terminated? How do suicidal patients differ in respect to 5HT? What effect do SSRIs have? Ecstasy?

A 

Essentialaa Tryptophan

CellbodiesinMedianandDorsalRaphe nuclei(Pons)

ActionterminationbyreuptakeorMAO‐A


Suicidalpatientsdemonstrate:

lowCSFmetabolitesofserotonin

lowconcentrationofserotoninuptakesitesonplatelets.

SSRIs(ex:fluoxitine)blocksreuptake and ↑5HTinsynaptic cleft

Ecstacy (MDMA):Blocksreuptake&↑ thereleaseof5HT

24
Q

Where does dopamine originate in the brain? What do misostriatal areas control? Misolimbic? Mesocortical? Tuberoinfundibular? How is the action of DA terminated? What effect does amphetamine have? Cocaine? reserpine? Parkinsons?

A 

OriginateformtheVentralTegmental area(MidBrain)

Misostriatal (movements)

Misolimbic(reward,hallucination)

Mesocortical (neurocognitive)

Tuberoinfundular

ActionterminationMAO‐BandCOMT

Amphtamine

increaserelease(improvemood,mania)

Cocaine

stimulaterelease/blocksreuptake(mania)

Reserpine

depletesDA(depression&amp;movementd/o)

Parkinson'sdiseases

(depressionandmovementd/o)
25
Q

Where are the cell bodies associated with NE located? How is its action terminated? What happens in depressed subjects? What supports its role in depression?

A 

CellbodiesinLocusCeruleus (upperPons)

ActionterminationbyreuptakeMAO
‐
AandCOMT

Upregulation ofpost
‐
synapticadrenergicreceptorsoccur
indepressedsubjects

NE modulatingantidepressantdrugs(desipramine)
stronglysupporttheimportantroleofNEindepression

Theantidepressent Mirtazapine Blocks
α2presynaptic receptor↑releaseNE&5HT
26
Q

What plays a central role in regulation of neuroendocrine functioning? What are 3 major neuroendocrine dysfunctional axes that are affected by mood disorders?

A


Thehypothalamusplaysacentralroleinregulationof
neuroendocrine functioningandreceivesneuronal
(5HT,Dopamine,NE,Acetylcholine,Histamines)

Theneuroendocrine abnormalitiesseeninmooddisorders
likelyrepresentanunderlyinglargerbraindysregulation.

Themajorneuroendocrine dysfunctionalaxesaffectedby
mooddisorders:


Adrenalaxis

Thyroidaxis

Growthhormoneaxis.

27
Q

How is the adrenal system associated with depression? What is a test for this? In what ways is it useful/not? What effect can prednisone have?

A


Hypersecretion ofcortisol anddepression(longknownassociation)

Dexamethasone suppressiontest


NOTusefulasadiagnostictool(highlyspecific,butnotsensitive)

Maybepredictiveoflikelihoodofrelapse

Ontheotherhandprednisone(syntheticcorticosteroid)caninducemania/hypomnia issusceptibleindividuals

28
Q

What is the association between the thyroid axis and depression? How does it work? How can this be used for treatment? How does this relate to mania?

A


Allnewcasesofdepressionshouldscreenedforthyroid
problems

1/3depressedindividualswithnormalthyroidfunction
haveabluntedreleaseofTSH(thyrotropin)bythe
pituitarytotheadministrationofTRH.


SimilarabnormalitiesofTSHbluntinghavebeennotedin
otherpsychiatricdisorders

Liothyronine(T3)usedtoaugmentantidepressent tx

thyrotoxicosis canmimicaManicpresentation

29
Q

Describe the cognitive theory?

A 

OriginallyproposedbyAaronBeck.

AutomaticThoughts

causessadness/anxiety/irritibility

CognitiveDistortions:

All‐or‐NothingThinking

FortuneTelling(catastrophizing)

EmotionalReasoning

MindReading,etc.

NegativeCorebeliefs:

trustothers(theworldisahosteltome)

controlmyselforenvironment(thingswillneverchange)

Selfesteem(Iamanineffectiveperson)

Thetherapistwilltrytohelpthepatientbeawareofcognitive distortionandchallengeAutomaticThoughts(earlyon)resultingin reducesymptoms.
30
Q

Describe the behavioral model.

A


LearnedHelplessness

Animalmodel:ratsgivensequentialelectricshockseventually
makenoattempttoescapeandstopeating

AdaptiveandMaladaptiveBehaviors

Isanythingreinforcingamaladaptivebehavior?(Operant
Conditioning)

Isthereanythingthatextinguishesadesiredbehavior?(Classical)

Isthereanassociationbetweenabehaviorandenvironmental
cuethatinitiatethebehavior?(ClassicalConditioning)

Ex:Therapistattemptingtotreatdepressionbyteachingthe
patienttoperceivesomecontroloverher/hisenvironment

31
Q

What is the stress diathesis model? What are some events that predict depression later in like? What events are most likely followed by depression? What is kindling?

A


Stress‐Diathesismodel=Vulnerbility (Geneticsand/orpsychological)

Eventthatpredictsdevelopmentofdepressionlaterinlife:
 lossofaparentbeforetheageof11
 Neglectininfancy
 Sexualabuse

Eventmostlikelytobefollowedbydepression:
 LossofaSignificantOther
 Deathofcloserelative
 Victimofassault
 Maritalproblems(serious)
 Dealingwithseparationordivorce
 Lossofjob/financialstressors/Lossofhousing/legalproblems/poorsupportsystem

Kindling(easiertorelapsewithlessornostress)
 MayrepresentchangesinthefunctionofneurotransmitterCircuitsorintraneuronal signaling mechanisms

Behavioral Medicine and Health (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions