Mood Disorders

Question 1

Epidemiology of depression

Answer 1

50% in treatment
Age if onset: 30
18-44 highest rate
Risks: unemployed, separated, divorced, urban, female

Question 2

WHO estimates depression affects _________ people worldwide, and is projected to increase
The US has similar rates with the world

Answer 2

~ 120 million

Anxiety is the most common mental disorder
Mood disorders (depression, bipolar) also very prevalent

Question 3

Depression Pathophys unknown
NOT a __________________
No single area of brain pathology
Likely involves alterations in neural circuitry

Answer 3

“chemical imbalance”

Question 4

Pts sleep and eat more
Lead limbs / lead paralysis
mood reactivity, leaden paralysis, reverse neurovegetative symptoms (increased appetite, weight gain, hypersomnia)

Answer 4

Atypical depression

Question 5

Often with auditory hallucinations, nihilistic delusions

Answer 5

psychotic depression

Question 6

More depressed in the morning

mood worse in the morning, early morning awakening, anorexia, weight loss, guilt, psychomotor retardation

Answer 6

melancholic

Question 7

Mood typically worsens in the fall and winter, improves in the spring and summer.

Answer 7

Seasonal Affective

Question 8

Bipolar disorder is best considered on a spectrum, ranging from extreme mood swings to cyclothymia to hypomanias + major depression (Bipolar II) to frank manias (Bipolar I).

Manias can be induced by medications (most often ________) or brain injuries (secondary manias)

Answer 8

antidepressants or steroids

Question 9

disorder involves periods of severe mood episodes from mania to depression

Answer 9

Bipolar 1

more severe

Question 10

hypomania that alternate with periods of severe depression.

Answer 10

Bipolar 2

Question 11

Discuss risk factors for suicide, demographics, and epidemiology.

Answer 11

• 1.4% all deaths in US and the 11th leading cause of death all ages
• 2nd leading cause of death 25-34 year olds
• In the US, ~ 300,000 attempts and 33,000 completed suicides per year.
• 10-15% of patients with severe MDD suicide
• 4:1 Male:Female suicide ratio
• 79 % of those who commit suicides are men
• Women attempt suicide 2-3X more often than men
• 2/3 of all completers had contact with PCP within a month of their suicide
• 56-75% of first attempts end in death
• 3-7% of all attempters will eventually kill themselves