Mood disorders

Question 1

1) Neuropsych diseases account for ___ causes of world wide disability
2) depression affects ___ people worldwide
3) depression and mood disorders = ___% of all disability
4) what is #1 and #2 most common psych illness

Answer 1

1) more than half
2) affects 120 million people
3) 25% of all disability

4) #1 = anxiety disorder
#2 = mood disorder

Question 2

diagnosis of depression requires

Answer 2

5+ symptoms of depression for 2+ weeks

change from previosu function

AND sad mood or anhedonia

Question 3

symptoms of depression

Answer 3

SIGECAPS

1) sleep (insomnia/hypersomnia)
2) interest decr
3) guilt excessive
4) energy decr
5) appetite decr
6) concentration decr
7) anhedonia
8) psychomotoric changes (incr or decr activity)
9) suicidal ideation- plan or intent

Question 4

subcategories of depression

Answer 4

1) atypical
2) psychotic depression
3) melancholic
4) seasonal affective

Question 5

subcategories of depression
atypical

describe
treatment

Answer 5

mood reactivity
leaden paralysis
incr appetite, weight gain, hypersomnia

responds to antidepressants better
high incidence with bipolar depression

Question 6

subcategories of depression
psychotic depression

symptoms
treatment

Answer 6

occur with auditory hallucination = no good, kill self

nihilistic delusion, delusion of poverty

treat = antipsych + antidepressiants

Question 7

subcategories of depression

melancholic

Answer 7

mood worse in morning
anorexia, weight loss
guilt
psychomotor retard

Question 8

subcategories of depression

seasonal affective

Answer 8

worse in fall/winter

better spring/summer

Question 9

bipolar disorder
diagnosis
bipolar 1 vs 2

Answer 9

bipolar 1 = frank mania (3:1 depression: mania)

bipolar 2 = hypomania (shorter mania, less social problem) + major depression (37:1)

Question 10

bipolar disorder

4 domains

Answer 10

1) manic mood and behavior = euphoria, grandiosity, pressured speech, impusle, incr libido, reckless, decr need for sleep
2) dysphoric mood and behavior = depression, anxiety, hostile, suicide
3) psychosis = delusions, hallucinations
4) cognitive symptoms = racing thoughts, disorganize, inattentive

Question 11

manias

diagnosis

Answer 11

abnormally and elevate expansive or irritable mood for 1+ week

w/ 3 or more symptoms = euphoric

w/ 4 or more symptom = irritable

Question 12

mneumonic for symptoms of mania

Answer 12

DIGFAST

1) distractability
2) insomnia
3) grandiosity
4) flight of ideas
5) activity (incr energy/activity)
6) speech (pressure/nonstop)
7) thoughtlessness

Question 13

hypomaniac symptoms

Answer 13

same as mania but not as long and not as significant social impairment

DIGFAST but LESS

Question 14

DDx for mood disorder –> depressive diosrder

Answer 14

1) disruptive mood dysregulation disorder = severe recurrent tempers, kids
2) major depressive disorder
3) persistent depressive disorder (dysthymia)
4) substance/med induced depression
5) premnstrual dysphroic disorder
6) other specified

Question 15

DDx for mood disorder –> bipolar disorder

Answer 15

1) bipolar 1
2) bipolar 2
3) cyclothymic disorder
4) substance/med induced bipolar
5) other specified bipolar
6) unspecified bipolar and related diosrder

Question 16

DDx mood symptoms + medical illness

Answer 16

1) endocrine = cushings, thyroid
2) infection = HIV, flu, CJD
3) CNS = stroke, tumor, MS, epilepsy
4) metab = hypercalcemia

Question 17

DDx mood + substance abuse

Answer 17

cocaine
etoh
stim
hallucinogens
benzodiazepine

Question 18

ddx mood + med side effect

Answer 18

prescribed med = amantidine, interferon, steroid, chemotherapy

med withdrawal = methyldopa

Question 19

theory behind mood disorder

Answer 19

no one clear etiology

complex interaction btwn medical illness, character, stress, genetics

Question 20

which is more heritable bipolar or depression

Answer 20

bipolar

Question 21

t or f mood disorders are chemical imbalances

Answer 21

false

involve multiple circuits = NE, 5-HT, DA, HPA

NT disrupted in amygdala, PFC, cingulate, thalamus, hippocampus

Question 22

how is HPA axis involved in mood disorder

Answer 22

1) HPA activated by stress
2) stim release of CRF –> ACTH –> cortisol
3) normally hippocampus inhib HPA but prolonged cortisol under stress –> damages hippocampal neurons –> elevated cortsiol, hippocampus atrophy

Question 23

how common is suicide as cause of death

what about in 25-34 y/o

of attempts for every completed suicide in older than 65

Answer 23

1) 11th cause of death
2) 2nd cause of death

3) 4 attempt for 65 +
100-200 attempt for less than 65

Question 24

___ had contact with PCP prior to suicide

___ of first attempts end in death

___ % attempters kill themselves

male vs female for completed suicide

male vs female for attempted suicide

Answer 24

2/3 see PCP

56-65% of first attempt –> death

3-7% attempt kill themsleves

men = 4:1 completed suicide

women = 2-3x more likely to attempt