Mood disorders

Question 1

most common psych illnesses

Answer 1

1st: anxiety d/o
2nd: mood d/o

Question 2

is depression a result of chemical imbalance?

Answer 2

NO

Question 3

Cause of depression and bipolar d/o

Answer 3

disruption of neural circuitry (amygdala, PFC, cingulate gyrus, striatum, thalamus, hippocampus)

Question 4

Which neurotransmitters modulate the neural circtuiry involved in depression and bipolar?

Answer 4

5HT, DA, NE

Question 5

Physiology of stress

Answer 5

stress –> HPA axis activation –> CRF release from paraventricular nucleus of hypothalamus –> ACTH from anterior pituitary –> cortisol from adrenal cortex –> inhibition of HPA

Question 6

Stress effects on hippocampus

Answer 6

HPA axis activation –> hippocampal activation –> inhibition of HPA

Question 7

Neuroendocrine dysfunction associated with depression

Answer 7

sustained elevation of glucocorticoids (cortisol) –> hippocampal damage –> decreased inhibition on HPA –> further increase in glucocorticoid levels –> hippocampal atrophy

Question 8

Stress effects on amygdala

Answer 8

Stress –> HPA axis activation –> amygdala excitation –> excitatory effects on HPA

Question 9

Depression diagnostic criteria

Answer 9

5 or more SIG E CAPS sx for 2 weeks or more.  MUST include sad mood and anhedonia
S = sleep (insomnia/hypersomnia)
I = Interest (diminished)
G = Guilt (excessive)
E = Energy (decreased)
C = Concentration (decreased)
A = Anhedonia
P = Psychomotor changes 
S = Suicidal ideations

Question 10

Atypical depression

Answer 10

mood reactivity, leaden paralysis, increased appetite, weight gain, hypersomnia

Question 11

Psychotic depression

Answer 11

depression with hallucinations and nihilistic delusions

Question 12

Melancholic depression

Answer 12

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

Question 13

seasonal affective depression

Answer 13

mood worse in fall/winter, improves in spring/summer

Question 14

Bipolar I

Answer 14

frank manias

Question 15

Bipolar II

Answer 15

hypomanias + major depression

Question 16

Bipolar symptoms

Answer 16

Manic mood and behavior, dysphoric mood and behavior, psychosis, cognitive symptoms

Question 17

Bipolar diagnostic criteria

Answer 17

Euphoric mania + 3 or more sx OR Irritable mania + 4 or more sx

DIGFAST
D = distractibility
I = insomnia
G = Grandiosity
F = flight of ideas
A = Activity
S = speech
T = thoughtlessness

Question 18

Hypomania

Answer 18

symptoms do not persist as long as mania (~4 days) and do not cause the degree of social impairment

Question 19

In which mood state do bipolar patients spend the majority of their time?

Answer 19

Depression

Question 20

Differential diagnosis with mood symptom presentation

Answer 20

Mood disorder, endocrine dysfunction, infectious etiology, CNS, hypercalcemia, Substance abuse, Med side effect, personality disorder

Question 21

Mood symptom presentation, endocrine differential dx

Answer 21

Cushings, hyper/hypothyroidism, steroids

Question 22

mood symptoms presentation, infectious differential dx

Answer 22

HIV, influenza, meningitis, CJD

Question 23

mood symptoms presentation, CNS differential dx

Answer 23

stroke, tumor, MS, epilepsy

Question 24

Mood symptom presentation, med side effect differential dx

Answer 24

amantadine, methyldopa withdrawal, interferon, steroids, chemo

Question 25

2nd leading cause of death for 25-34yo

Answer 25

suicide

Question 26

suicide risk factors

Answer 26

MDD, male