Mood Disorders

Question 0

Patient presents with possible depression – most common medical cause?

Most common neurologic associations?

Answer 0

Hypothyroidism

Parkinson’s and dementia

Question 1

Major depression criteria?

Answer 1

4 of SIG E CAPS
#Sleep disturbances
#Decreased interest
#Guilt
#Decreased energy 
#Decreased concentration
#Decreased appetite
#Psychomotor retardation
#Suicidal ideation

Question 2

Treatment for depression?

If some improvement but not full response? Do not take with?

Other therapies?

Answer 2

SSRIs

Increase dose; MAOIs

Cognitive behavioral therapy

Question 3

Patient with depression and neuropathic pain – best drug?

Patient with depression who does not want to gain weight or have any sexual side effects – best drug?

Answer 3

Duloxetine

Bupropion

Question 4

Patient presents with manic symptoms – rule out?

Answer 4

Cocaine/ amphetamine use with drug tox screen

Question 5

Mania versus hypomania?

Answer 5

Last more than one week, affects functioning, and can warrant hospitalization

Under one week, not severe enough to affect functioning, not severe enough to warrant hospitalization

Question 6

Bipolar type I versus type II?

Answer 6

Mania and depression

Versus

Hypomania and depression

Question 7

Treatment for severe acute mania?

Answer 7

#Li or Valproic acid
#Atypical antipsychotics
#Sedating medication

Question 8

Treatment for bipolar depression?

Answer 8

#Lithium
#Lurasidone
#Lamotrigine

Question 9

Contraindication to lithium?

Answer 9

Renal insufficiency

Question 10

Dysthymia? Treatment?

Answer 10

Constant depressed mood for two years

Psychotherapy and antidepressants

Question 11

Cyclothymia? Treatment?

Answer 11

Hypomanic episodes and mild depression for more than two years

#Lithium or valproic acid or carbamazepine
#Psychotherapy

Question 12

Atypical depression characterized by? Treatment?

Answer 12

#Increased sleep
#Increased weight
#Increased appetite

Mood worse in the evenings

SSRIs or MAOIs

Question 13

Seasonal affective disorder symptoms? Treatment?

Answer 13

Weight gain, increased sleep, lethargy in fall and winter

Phototherapy and bupropion

Question 14

Postpartum blues versus postpartum depression versus postpartum psychosis – onset?

Answer 14

From birth to two weeks

1-3 months after birth

2-3 weeks after birth

Question 15

Postpartum blues versus postpartum depression versus postpartum psychosis – Symptoms and thoughts toward baby?

Answer 15

Sadness, mood lability, tearfulness but no negative feelings toward baby

Depression, weight changes, sleep disturbances, and anxiety. May have negative feelings toward baby

Depression, delusions, thoughts of harm toward self or baby

Question 16

Postpartum blues versus postpartum depression versus postpartum psychosis treatment?

Answer 16

Supportive

Antidepressants

Antipsychotics, Li, and possibly antidepressants

Question 17

Bereavement – typically last for? Treatment?

Answer 17

Less than six months

Supportive psychotherapy (no medical therapy)

Question 18

Signs that point to major depression rather than bereavement?

Answer 18

#Suicidal ideation
#Worthlessness
#Psychomotor retardation or functional impairment
#Psychosis
***Symptoms lasting longer than two months