Mood Disorders Flashcards
Discuss common signs and symptoms of depression, and criteria for diagnosis
5 or more symptoms for two weeks or more, they are a change from previous, and feel sad or anhedonia S-sleep disturbances I- loss of interest G-guilt feeling worthless E- low energy C-concentration cognition decreased A-appetite disruption P-psychomotor dysfunction S-suicidal ideation
Discuss common signs and symptoms of bipolar disorder, and criteria for diagnosis
Distinct period of abnormally or distinctively elevated, expansive or irritable mood, persistently increased goal directed activity, present most of the day nearly everyday lasting at least 1 week + 3 more symptoms (euphoric) 4 or more symptoms (if irritable). D- distractibility I- insomnia G- grandiosity F- flight of ideas A- activity increased S- speech T- thoughtlessness
Discuss subcategorization of depression (atypical, psychotic, melancholic)
- Atypical: mood reactivity, leaden paralysis, reverse neurovegetative symptoms (increased appetite, weight gain, hypersomnia)
- Psychotic depression (often with auditory hallucinations, nihilistic delusions)
- Melancholic: mood worse in the morning, early morning awakening, anorexia, weight loss, guilt, psychomotor retardation.
- Seasonal Affective: Mood typically worsens in the fall and winter, improves in the spring and summer.
Discuss the differential diagnosis of mood disorders
- mood disorder
- medical illness
- Endocrine: e.g. Cushings, Hyper/hypothyroidism, steroids)
- Infections: e.g. HIV, influenza, meningitis, Creutzfeld-Jakob
- CNS: e.g. stroke, tumor, Multiple Sclerosis, epilepsy
- Metabolic: e.g. hypercalcemia - substance abuse
- Cocaine, Alcohol, Amphetamine/stimulants, Hallucinogens (LSD, PCP, mescaline), Benzodiazepines - medication S/E
- Amantadine, Methyldopa withdrawal, Interferon, steroids, chemotherapy agents - personality
Discuss current theories concerning etiology and pathophysiology of major depression and bipolar disorder.
complex neuropsychiatric disorders • Mood disorders are heritable, though the current genetic transmission is poorly understood (multiple genes + environment Bipolar more heritable than unipolar, dysruptions of neural circuitry, neuroenddocrine dysfunction
Discuss risk factors for suicide, demographics, epidemiology
11th leading cause of death all ages, 7th for young adults MAle 4:1 Females, females make more attempts, family hx
Discuss the epidemiology of mood disorders and disability, both world wide and in the United States.
neuropsychiatric diseases account for half of all causes of disability worldwide.
Depression affects approximately 120 million people worldwide
what is the most common psychiatric illness
anxiety disorders
discuss bipolar disorder .
is on a spectrum, ranging from extreme mood swings to cyclothymia to hypomanias + major depression (Bipolar II) to frank manias (Bipolar I).
Bipolar disorder symptoms can be divided into 4 domains:
• manic mood and behavior (euphoria, grandiosity, pressured speech, impulsivity, excessive libido, recklessness, social intrusiveness, and diminished need for sleep,
• dysphoric mood and behavior (depression, anxiety, irritability, hostility, and violence or suicide)
• psychosis (delusions and hallucinations)
• cognitive symptoms (racing thoughts, distractibility, disorganization, and inattentiveness).
• There is no clear etiology of bipolar disorder, and is likely the complex interaction between a number of genes, other neurobiological vulnerabilities, environment, stress, possible white matter abnormalities.
(bipolar I and II disorder)
Patients only have to have mania to be diagnosed with bipolar I disorder; they must have hypomania + major depression to be diagnosed with bipolar II disorder.
where do most patients spend majority of time mania or depression
most patients with bipolar disorder spend the majority of their mood states in depression.
