mood disorders Flashcards
criteria for major depressive disorder
at least five symptoms one of which is either depressed mood or anhedonia for greater than 2 weeks
Depressed mood
Anhedonia
Decrease or increase in appetite OR significant weight loss or gain
Persistently increased OR decreased sleep
Psychomotor agitation OR retardation
Fatigue/low energy
Feelings of worthlessness or inappropriate guilt
Decreased concentration or indecisiveness
Recurrent thoughts of death, suicidal ideation, or suicide attempt
common associated symptoms with major depressive disorder - from most to least common
anxiety
somatization
psychosis
criteria for dysthymic disorder
depressed mood for greater than two years with no more than two months symptom free and at least two of the following:
decreased or increased appetite decreased or increased sleep low energy or fatigue low self-esteem poor concentration or indecisiveness hopelessness
criteria for manic episode
elevated OR irritable mood and three (four if irritable) of the following all for longer than 1 week with significant dysfunction:
Grandiosity Decreased need for sleep Pressured speech Flight of ideas, racing thoughts Distractibility Increased goal-directed activity Excessive involvement in pleasurable activities with high risk
criteria for hypomanic episode
elevated OR irritable mood and three (four if irritable) of the following for greater than 4 days with limited dysfunction:
Grandiosity Decreased need for sleep Pressured speech Flight of ideas, racing thoughts Distractibility Increased goal-directed activity Excessive involvement in pleasurable activities with high risk
criteria for mixed episode
combination of manic and depressive symptoms for greater than a week with significant dysfunction
criteria for bipolar I disorder
- At least one manic or mixed episode
- No need for a prior depressive episode
- More severe illness than Bipolar II and easier to diagnose
criteria for bipolar II disorder
- At least one previous major depressive episode
- At least one hypomanic episode
- Less severe than BP I; difficult to diagnose
cyclothymia
- Fluctuating minor depressive, hypomanic episodes
- No prior major depressive, manic or mixed episodes
- Over 2 year period, no symptom free period > 2 months
- After 2 years, Bipolar I or II may develop
age of onset of major depressive disorder
- any age but average is 30
- 6-8 year delay from first symptom to first treatment
dysthymic disorder age of onset
- any age but average is 30
dysthymia is often comorbid with….
personality disorders of clusters B and C
age of onset of bipolar disorders
late teens to early 20s
what percent of life is symptomatic in bipolar disorder and what percent is depression?
33-50% symptomatic
67% depressed
medications for depression
- MAO-Is, TCAs, SSRIs
- others: venlafaxine, mirtazapine, trazodone, nefazodone, vilazodone, bupropion
