Mood Disorders Flashcards

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1
Q

What is the most prominent feature of any mood disorder?

A

Actual disturbance in MOOD (irritable, elevated, expansive, dysphoric, etc)

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2
Q

What are some general health conditions that have a high prevalence of depression?

A

Alzheimer’s disease, stroke, heart disease, cancer, diabetes, HIV/AIDS, end-stage renal failure, Parkinson’s, chronic fatigue/fibromyalgia, chronic pain.

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3
Q

Do people who have co-existing depression and medical illness tend to have less or more severe symptoms of both?

A

More severe (also more difficult adapting and more medical costs)

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4
Q

How can treating the depression alone in a patient with a co-existing medical illness affect that person’s overall health?

A

Can actually improve the outcome of the treating the medical illness

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5
Q

What are the “7 secrets” of depression?

A

1 common 2 often missed 3 not hard to diagnosis when looking for it 4 often severe 5 often recurrent 6 costly 7 highly treatable

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6
Q

How common is depression?

A

One of the five most common disorders seen by primary care physicians

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7
Q

Is depression more common in men or women?

A

Women (1.5-3X)

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8
Q

How commonly is depression overlooked by both the patient and doctor?

A

50% of cases

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9
Q

How often do those with depression experience recurrence?

A

More than 50%

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10
Q

When untreated, how long do recurrent episodes of depression usually last?

A

6-24 months

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11
Q

What is the LEADING cause of disability in the US for those ages 15-44?

A

Depression

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12
Q

What defines a major depressive episode?

A

At least 2 weeks of depressed mood or loss of interest in all activities AND 4 additional symptoms of depression

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13
Q

What are the additional symptoms of depression?

A

Changes in appetite or weight, insomnia or hypersomnia, decreased energy, agitation or retardation, feeling worthless or guilt, difficulty thinking or concentrating, recurrent thoughts of suicide or death

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14
Q

Instead of reporting feelings of sadness, what kinds of complaints do depressed patients usually present with?

A

Somatic ones in nature (also irritability, anhedonia, and apathy)

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15
Q

How common is postpartum onset depression within the first year after delivery?

A

10-15%

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16
Q

What are the subtypes of major depressive disorder?

A

Psychotic features, seasonal pattern, melancholia, atypical, postpartum onset

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17
Q

What are the conditions for dysthymic disorder?

A

Only 3 of the listed symptoms of depression BUT be present for 2 YEARS

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18
Q

Which is more prevalent: dysthymic disorder or major depressive disorder?

A

Dysthymic disorder (super common with many health conditions)

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19
Q

What kind of diagnosis is given when there are depressive symptoms about which there is inadequate or contradictory information?

A

Depressive order not otherwise specified

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20
Q

What are examples of screening tools for depression?

A

Beck, Hamilton, and Reynolds depression inventories, Reynolds adolescent depression scale, national mental health screening test, NYU medical center depression screening

21
Q

When talking to patients about their depressive symptoms, what are the 3 main factors of the the symptoms to focus on?

A

1 duration 2 persistence 3 severity

22
Q

How can depression be treated?

A

Cognitive behavior therapy, interpersonal therapy, SSRIs (Prozac, Zoloft, Celexa), SNRIs (Effexor, Cymbalta), electroconvulsive therapy

23
Q

What nutritional levels play a role in depression?

A

Lower levels of vitamin B6, magnesium, vitamin D, calcium, and omega 3s along with higher levels of PTH

24
Q

Why do levels of vitamin B6 and magnesium play a role in depression?

A

Both essential for the formation of serotonin

25
Q

How can chiropractic care help depression?

A

Reduction of pain = less depressive symptoms in many cases (think about changing scores on assessments)

26
Q

What characterizes bipolar I disorder?

A

One or more manic or mixed episodes (usually accompanied by major depressive episodes)

27
Q

What is a manic episode, technically?

A

A distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood lasting for at least ONE WEEK accompanied by at least 3 additional symptoms

28
Q

What are the additional symptoms of bipolar I disorder?

A

Inflated self-esteem, decreased need for sleep, pressure of speech, flight of ideas, distractibility, excessive involvement in pleasurable and/or goal-directed activities

29
Q

What is a mixed episode in reference to bipolar I disorder?

A

A time where criteria are met for both a manic episode and major depressive episode nearly every day for at least 1 week

30
Q

What characterizes a bipolar II disorder?

A

One or more major depressive episodes accompanied by at least one hypomanic episode

31
Q

What is a hypomanic episode?

A

Abnormal and persistently elevated, expansive, or irritable mood that lasts at least 4 days and includes 3 additional manic symptoms

32
Q

Which is more severe: manic or hypomanic episode?

A

Manic

33
Q

Which does not completely disrupt functioning: manic or hypomanic episode?

A

Hypomanic episode (also doesn’t require hospitalization)

34
Q

What characterizes a cyclothymic disorder?

A

At least a 2 year duration of mood swings that fluctuate between hypomania and MINOR depression

35
Q

What is the gender bias for bipolar disorder?

A

NONE (equally common)

36
Q

There is a strong genetic evidence for which form of bipolar disorder?

A

Bipolar I disorder

37
Q

What is the mean age of first impairment of bipolar disorder?

A

18.7 years

38
Q

What medication can be used for bipolar disorder as long-term prevention?

A

Lithium (mood stabilizer), Depakote, Tegretol, Lamictal, Neurontin, Topamax (anticonvulsants)

39
Q

What other things can help treat bipolar disorder besides medication?

A

Psychosocial treatment, prodromal detection, charting progress and days

40
Q

What is prodromal detection in reference to bipolar disorder?

A

Using early warning signs that indicate bipolar disorder relapse

41
Q

Higher rates of which medical conditions are commonly seen in those with bipolar disorder?

A

Obesity, hypertension, dyslipidemia, and diabetes (think omega 3 approach!)

42
Q

What are some medical conditions that can lead to a possible mood disorder?

A

Parkinson’s, Huntington’s, CVD, metabolic conditions, endocrine conditions, autoimmune disease, infections, some cancers

43
Q

Is suicide common?

A

Top ten cause of death overall, top 3 in young adults and teens (global issue)

44
Q

What must a physical do when a patient reveals suicidal ideation?

A

MUST consider psychiatric consultation and hospitalization

45
Q

What is unique about the doctor visit time frame of individuals who commit suicide?

A

Many have visited a physician during the month before they take their lives

46
Q

How prevalent is suicide among bipolar patients?

A

COMMON: 25-50% attempt it at least once

47
Q

What specific population of people are at an increased risk of suicidal thoughts and attempts?

A

College students

48
Q

What are some effective suicide interventions?

A

Restriction of methods of suicide, crisis centers, prevention/treatment of depression and substance abuse, school-based interventions