Mood Disorders Flashcards
Dissociation
splitting off clusters of mental contents from conscious awareness
Intellectualization
engagement in abstract thinking to ward off conflict or disturbing feeling
Projection
what is emotionally unacceptable in the self is unconsciously rejected and attributed to others
Rationalization
attempts to make unacceptable feeling acceptable by justification
Reaction formation
person adopts ideas and behaviors that are the opposite of impulses harbored consciously or unconsciously (ie, excessive moral zeal may be a reaction to strong but repressed asocial impulses)
Sublimation
unacceptable conscious drives are redirected into personally and socially acceptable channels
Substitution
an unacceptable emotion is replaced by one that is more acceptable
Mood Disorders: 3 Major Divisions
- Depressive Disorders
- Bipolar Disorders
- Depression associated with medical illness/alcohol/substance abuse
Mood Disorders are defined by
a pattern of episodes over time
Major Depressive Episode (DSM-IV and DSM-5) Definition
(A)
At least five of the following symptoms nearly every day for two weeks:
- Depressed mood (or irritability in adolescents)
- Anhedonia
- Change in weight or appetite
- insomnia or hypersomnia
- psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Diminished ability to think or concentrate
- Recurrent thoughts of death or suicide
Major Depressive Episode (DSM-IV and DSM-5) Definition
(B-F)
B. Impairment or distress
C. No organic factor. Bereavement is no longer an exclusion in DSM-5.
D. Mixed state now a specifier.
E. No schizophrenia or schizoaffective disorder
F. Anxiety now a specifier.
Pathophysiology of MDE
- Increased cortisol/CRH
- 2nd messenger system changes
- transcription factor changes
MDD occurs in ___% of the population
15%
MDD Diagnosis involves alterations in… (7)
Increased risk for what?
- Mood
- Appetite
- Sleep
- Energy
- Activity
- Thoughts
- Cognition
Increased suicide risk.
Questions to probe for anhedonia
Change in:
- Sex drive?
- Activities/hobbies?
- Enjoyment of being by yourself or with others?
Typical and atypical change in sleep in MDD
Redced sleep is typical, increased is atypical
increased sleep is generally not restful
In MDD, look for ___ or ___ ideas
delusional or overvalued
If a person has tried to harm themselves, has come close, or has persistent thoughts of suicide, assess ________.
for dangerousness
Manic Episode Dx (A-E)
Elevated or expansive lasting at least one week
Elevated or irritable mood characterized by:
- Grandiosity
- Little need for Sleep
- Pressured speech
- Distractibility
- Increase in activities- goal directed and risk taking
DOESNT meet criteria for mixed episode
Marked impairment in function
Not due to substance or medical condition
Manic episodes commonly manifest as what two types of mood
Elevated or irritable
Question to check for grandiosity
“Have you felt that you were a very important person or that you had special plans, powers, talents, or abilities?”
Question for delusional ideas?
- ´Has there ever been a time when you’ve had ideas that you later realized were not true?
- How about ideas that you felt very sure about but no one else believed?”
Mixed episode =
Over a 1 week period, patient satisfies criteria for both Manic episode and MDE
Differnce between mania and hypomania
Mania requires a week of elevated mood plus 3-4 symptoms;
Hypomania requires 4 days plus 3-4 symptoms
**Hypomania may include mild or moderate impairment, but may also be associated with enhancement of function
