mood disorders Flashcards
1
Q
MDE: criteria
A
- > =5 of SSIGECAPS
- for at least a 2 week period
2
Q
manic episode
A
- abnl expansive/elevated/irritable mood
- > =3 (or >= 4 if irritable mood) of DIGFAST
- lasting at least 1 week
- must cause social/occupational impairment
- 75% of manic pts have psychotic sx
3
Q
manic vs hypomanic
A
- manic: >= 7d (hypomanic: >= 4d), severe impairment, hospitalization may be necessary, psychotic features
4
Q
mixed episode
A
- criteria met for MDE and manic episode
- present nearly every day for >= 1 wk
- irritability usually predominant mood
- poorer response to lithium
5
Q
MDD: diagnosis
A
- may be unaware of depressed mood, may express vague somatic complaints
- > = 1 MDE, no manic/hypomanic episodes
6
Q
MDD: epidemiology
A
- 16.2% lifetime prevalence in US
- avg age of onset 40
- 2x prevalence in women in reproductive years
- women=men in pre and post reproductive years
- 25-50% prevalence in elderly
- increases mortality in other comorbidities
- highest suicide rate of any d/o
7
Q
MDD: sleep disturbances
A
- multiple awakenings
- initial and terminal insomnia (most common disturbance)
- hypersomnia
- REM shifted earlier, decreased stages 3 and 4
8
Q
MDD: pathophys
A
- decreased 5HT and 5HIAA (metabolite) in CSF
- abnl regulation of beta-adrenergic rcptrs
- high cortisol
- abnl thyroid axis
- psychosocial, genetic contribution
9
Q
MDD: prognosis
A
- depressive episodes 6-13 mos untreated
- episodes occur more frequently as d/o progresses
- risk of 2nd episode 50% w/in 2 yrs of first episode
- 15% will eventually commit suicide
- 50-60% have response to antidepressants
10
Q
MDD and ECT
A
- if unresponsive to pharmacotx, cannot tolerate, or need rapid reduction of sx
- premedication: atropine + GA and muscle relaxant
- electricity thru brain
- 8 treatments over 2-3 week period
- retrograde and anterograde amnesia common SE, disappears w/in 6 mos
11
Q
difft features of depressive d/os
A
- melancholic
- atypical: hypersomnia, hyperphagia, reactive mood, leaden paralysis, hypersensitivity ot interpersonal rejection
- catatonic: catalepsy, etc - especially responsive to ECT
- psychotic: 10-25% of hospitalized depression
12
Q
bereavement
A
- aka simple grief
- reaction to major loss
- sx lasting for 2 months
- if nl, no gross disorganization or suicidality
13
Q
normal grief vs depression
A
- normal grief: illusions common, suicidal thoughts rare; sx 2 mos; mild cognitive d/o lasts >1 yr
- tx of depression: antidepressants, mood stabilizers, ECT
14
Q
bipolar I diagnosis
A
- episodes of major depression NOT required
- one manic or mixed episode required
- may be interspersed euthymia, MDE, dysthymia, or hypomania
- may have psychotic during depressive or manic episodes
- rapid cycling: 4+ mood episodes in 1 yr
15
Q
bipolar I: epidemiology
A
- lifetime prevalence 1%
- women = men
- onset usually before 30 yo
