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Jason's MD3 Psychiatry Rot > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Feelings?

A

Compelling
‘Source of truth’
binding

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2
Q

Mood vs. affect

A

Mood: subjective (larger order experience -climate)

Affect: objective (moment by moment feelings - weather)

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3
Q

Depression Dx?

A

2+ weeks of: at least one of:

  • Depressed mood
  • Anhedonia (signature symptom
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4
Q

Depressed mood 3 description:

A

Quality
Reactivity
Diurnal pattern

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5
Q

2 types of depression:

A
  1. Neuro-vegetative (biological)
    - psychomotor retardation
  2. Cognitive affective symptoms
    - guilt
    - loss of self esteem and worthlessness
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6
Q

What more likely to have suicidal ideation?

A
  • Severe depression
  • Insomnia
  • Worthlessness
  • Guilt
  • Phase of recovery - so apathetic when depressed, but when treating can increase motivation to complete suicide
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7
Q

What is a criteria of severe depression?

A

Psychotic symptoms

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8
Q

Psychotic symptoms in severe depression: 6 kinds of delusions:

A

Delusions: guilt, persecution, poverty, hyper contrasts, catastrophe, nihilism

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9
Q

Why psychotic depression important to Dx or know?

A

Treatment is different:

Antipsychotic
Antidepressants
ECT

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10
Q

How long will you be depressed with moderate depression if untreated?

A

9 months

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11
Q

Postpartum depression, how many and when?

A

10% women during
4-12 weeks
50% recurrence

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12
Q

Depression in older adults factors?

A

Loss
Organic
Somatic complains
Irritable more than sad

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13
Q

What neurological conditions associated with depression?

A

Parkinson’s
Stroke: frontal lobe

Orbits-frontal dementia

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14
Q

What meds can trigger depression?

A 
Corticosteroids
Mono amine depletion
GABA-Ergic drugs: benzos, alcohol
Chemo
OC (rare)
Interferon
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15
Q

Psychiatric co-morbidities include these 3 and need parallel treatment

A

Alcohol/drug abuse
Anxiety
Personality

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16
Q

What isn’t depression:

A
  • Grief
  • anxiety
  • demoralization (loss of competence but still has hedonics)
  • adjustment disorder
  • delirium (hypo active)
  • normal sadness
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17
Q

Genes and depression heritability?

A

40-70%

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18
Q

Depression only emotion?

A
  • Brain structure changes

- Functional neurotransmitter changes

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19
Q

Interpersonal factors in childhood depression

A
  1. Parental loss + poor parenting
  2. chronic depressed mother
  3. Cumulative disadvantages
  4. Childhood sexual abuse
20
Q

what is Protective for depression in childhood?

A

Good relationship

Higher IQ

21
Q

Interpersonal factors in adult that is protective?

A

Married

Confiding in others

22
Q

Environmental factors for depression?

A 
Precipitating
Loss
Humiliation
Entrapment
Danger
23
Q

What environmental factors protective for depression?

A

Employment/Financial, status
Fresh starts
social capital

24
Q

How to treat mild/mod depression?

A

Psycho-social

  • problem solving
  • CBT (introduce alterity)
  • exercise
  • confiding other
  • couple therapy
  • lifestyle: sleep, diet, less alcohol)
25
Q

What kinds of pharmacological treatments for depression?

A 
SSRIs
SNRIs
Mirtazipine
TCAs
Lithium
T3
SGAs
26
Q

**How long to treat pharma for depression for?

A

6-12 weeks full dose

Maintain for 6-12 months post recovery in 1st episode.

27
Q

If someone is better from 1st episode depression with pharma, how to do treat?

A

Treat for 6-12 months after at treatment dose.

28
Q

ECT useful for?

A 
Melancholic
Psychotic
Puerperal
Bipolar or mania
Prominent suicidality
Poor oral intake
29
Q

Risk factors for bipolar:

A 
Genetic
Head injury
Organic CNS disease
AIDS
Season (spring/summer: mania)
Circadian rhythm disruption
Life events
30
Q

Symptoms of mania? 1a and 1b?

A

1a: elevated mood
1b: irritable mood

Subjective less need for sleep
Flight of ideas: thoughts moving too fast but still associated connections
Talkativeness
Distractibility
Risky behavioural
Increased sexual activity
31
Q

What is bipolar I in spectrum disorder?

A

At least 1 episode of mania. +/- depressive

32
Q

What is bipolar II in spectrum disorder?

A

Depressive episode + hypo-manic episode

33
Q

What is cyclothymia?

A

Dysphoric + hypo mania

34
Q

Ppl who are not psychotic when manic are what when depressed

A

Not psychotic

35
Q

Mania Dx conventions?

A

Mania: >1week
Hypo mania: >2-4 days
Rapid cycling: >4episodes per year
Mixed state 1-2 weeks

36
Q

Clinical pattern of bipolar:

A

Starts in Adolescence: brief, mild

  • median duration 4.5-7 months
  • kindling
  • 2x depressive episodes of unipolar pts
37
Q

Mania or depression

A

3x longer in depression than manic

38
Q

Bipolar vs. depression, who gets more episodes of depression

A

Bipolar: 2x more likely to get depressive episode.

39
Q

DDx for bipolar?

A
  1. Schizophrenia
  2. ORganic: orbito-frontal
  3. Drug induced psychosis: cocaine, cannabis etc.
40
Q

How to treat bipolar?

A
  • Mood stabilizers
  • lithium
  • SGAs-second Gen, anti
  • antidepressants
  • ECT
41
Q

If suicidal bipolar, how to treat?

A

Clozapine and

Lithium

42
Q

Primary indication for clozapine?

A

Treatment resistant schizophrenia

43
Q

Dysthymia is?

A

Chronic low mood

44
Q

Cyclothymia?

A

Mild mania

Mild depression

45
Q

Hyperthymia?

A

Slightly happier than normal all the time.

46
Q

What is an emotion

A 
a Complex action: 
facial expression
Postural
Visceral 
Thoughts

Jason's MD3 Psychiatry Rot (23 decks)

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