Mood disorders Flashcards
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
1) more than half
2) affects 120 million people
3) 25% of all disability
4) #1 = anxiety disorder #2 = mood disorder
diagnosis of depression requires
5+ symptoms of depression for 2+ weeks
change from previosu function
AND sad mood or anhedonia
symptoms of depression
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
subcategories of depression
1) atypical
2) psychotic depression
3) melancholic
4) seasonal affective
subcategories of depression
atypical
describe
treatment
mood reactivity
leaden paralysis
incr appetite, weight gain, hypersomnia
responds to antidepressants better
high incidence with bipolar depression
subcategories of depression
psychotic depression
symptoms
treatment
occur with auditory hallucination = no good, kill self
nihilistic delusion, delusion of poverty
treat = antipsych + antidepressiants
subcategories of depression
melancholic
mood worse in morning
anorexia, weight loss
guilt
psychomotor retard
subcategories of depression
seasonal affective
worse in fall/winter
better spring/summer
bipolar disorder
diagnosis
bipolar 1 vs 2
bipolar 1 = frank mania (3:1 depression: mania)
bipolar 2 = hypomania (shorter mania, less social problem) + major depression (37:1)
bipolar disorder
4 domains
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
manias
diagnosis
abnormally and elevate expansive or irritable mood for 1+ week
w/ 3 or more symptoms = euphoric
w/ 4 or more symptom = irritable
mneumonic for symptoms of mania
DIGFAST
1) distractability
2) insomnia
3) grandiosity
4) flight of ideas
5) activity (incr energy/activity)
6) speech (pressure/nonstop)
7) thoughtlessness
hypomaniac symptoms
same as mania but not as long and not as significant social impairment
DIGFAST but LESS
DDx for mood disorder –> depressive diosrder
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
DDx for mood disorder –> bipolar disorder
1) bipolar 1
2) bipolar 2
3) cyclothymic disorder
4) substance/med induced bipolar
5) other specified bipolar
6) unspecified bipolar and related diosrder
DDx mood symptoms + medical illness
1) endocrine = cushings, thyroid
2) infection = HIV, flu, CJD
3) CNS = stroke, tumor, MS, epilepsy
4) metab = hypercalcemia
DDx mood + substance abuse
cocaine etoh stim hallucinogens benzodiazepine
ddx mood + med side effect
prescribed med = amantidine, interferon, steroid, chemotherapy
med withdrawal = methyldopa
theory behind mood disorder
no one clear etiology
complex interaction btwn medical illness, character, stress, genetics
which is more heritable bipolar or depression
bipolar
t or f mood disorders are chemical imbalances
false
involve multiple circuits = NE, 5-HT, DA, HPA
NT disrupted in amygdala, PFC, cingulate, thalamus, hippocampus
how is HPA axis involved in mood disorder
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
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
1) 11th cause of death
2) 2nd cause of death
3) 4 attempt for 65 +
100-200 attempt for less than 65
___ 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
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
