Mood Disorders Flashcards
What is the most prominent feature of any mood disorder?
Actual disturbance in MOOD (irritable, elevated, expansive, dysphoric, etc)
What are some general health conditions that have a high prevalence of depression?
Alzheimer’s disease, stroke, heart disease, cancer, diabetes, HIV/AIDS, end-stage renal failure, Parkinson’s, chronic fatigue/fibromyalgia, chronic pain.
Do people who have co-existing depression and medical illness tend to have less or more severe symptoms of both?
More severe (also more difficult adapting and more medical costs)
How can treating the depression alone in a patient with a co-existing medical illness affect that person’s overall health?
Can actually improve the outcome of the treating the medical illness
What are the “7 secrets” of depression?
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
How common is depression?
One of the five most common disorders seen by primary care physicians
Is depression more common in men or women?
Women (1.5-3X)
How commonly is depression overlooked by both the patient and doctor?
50% of cases
How often do those with depression experience recurrence?
More than 50%
When untreated, how long do recurrent episodes of depression usually last?
6-24 months
What is the LEADING cause of disability in the US for those ages 15-44?
Depression
What defines a major depressive episode?
At least 2 weeks of depressed mood or loss of interest in all activities AND 4 additional symptoms of depression
What are the additional symptoms of depression?
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
Instead of reporting feelings of sadness, what kinds of complaints do depressed patients usually present with?
Somatic ones in nature (also irritability, anhedonia, and apathy)
How common is postpartum onset depression within the first year after delivery?
10-15%
What are the subtypes of major depressive disorder?
Psychotic features, seasonal pattern, melancholia, atypical, postpartum onset
What are the conditions for dysthymic disorder?
Only 3 of the listed symptoms of depression BUT be present for 2 YEARS
Which is more prevalent: dysthymic disorder or major depressive disorder?
Dysthymic disorder (super common with many health conditions)
What kind of diagnosis is given when there are depressive symptoms about which there is inadequate or contradictory information?
Depressive order not otherwise specified
What are examples of screening tools for depression?
Beck, Hamilton, and Reynolds depression inventories, Reynolds adolescent depression scale, national mental health screening test, NYU medical center depression screening
When talking to patients about their depressive symptoms, what are the 3 main factors of the the symptoms to focus on?
1 duration 2 persistence 3 severity
How can depression be treated?
Cognitive behavior therapy, interpersonal therapy, SSRIs (Prozac, Zoloft, Celexa), SNRIs (Effexor, Cymbalta), electroconvulsive therapy
What nutritional levels play a role in depression?
Lower levels of vitamin B6, magnesium, vitamin D, calcium, and omega 3s along with higher levels of PTH
Why do levels of vitamin B6 and magnesium play a role in depression?
Both essential for the formation of serotonin
How can chiropractic care help depression?
Reduction of pain = less depressive symptoms in many cases (think about changing scores on assessments)
What characterizes bipolar I disorder?
One or more manic or mixed episodes (usually accompanied by major depressive episodes)
What is a manic episode, technically?
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
What are the additional symptoms of bipolar I disorder?
Inflated self-esteem, decreased need for sleep, pressure of speech, flight of ideas, distractibility, excessive involvement in pleasurable and/or goal-directed activities
What is a mixed episode in reference to bipolar I disorder?
A time where criteria are met for both a manic episode and major depressive episode nearly every day for at least 1 week
What characterizes a bipolar II disorder?
One or more major depressive episodes accompanied by at least one hypomanic episode
What is a hypomanic episode?
Abnormal and persistently elevated, expansive, or irritable mood that lasts at least 4 days and includes 3 additional manic symptoms
Which is more severe: manic or hypomanic episode?
Manic
Which does not completely disrupt functioning: manic or hypomanic episode?
Hypomanic episode (also doesn’t require hospitalization)
What characterizes a cyclothymic disorder?
At least a 2 year duration of mood swings that fluctuate between hypomania and MINOR depression
What is the gender bias for bipolar disorder?
NONE (equally common)
There is a strong genetic evidence for which form of bipolar disorder?
Bipolar I disorder
What is the mean age of first impairment of bipolar disorder?
18.7 years
What medication can be used for bipolar disorder as long-term prevention?
Lithium (mood stabilizer), Depakote, Tegretol, Lamictal, Neurontin, Topamax (anticonvulsants)
What other things can help treat bipolar disorder besides medication?
Psychosocial treatment, prodromal detection, charting progress and days
What is prodromal detection in reference to bipolar disorder?
Using early warning signs that indicate bipolar disorder relapse
Higher rates of which medical conditions are commonly seen in those with bipolar disorder?
Obesity, hypertension, dyslipidemia, and diabetes (think omega 3 approach!)
What are some medical conditions that can lead to a possible mood disorder?
Parkinson’s, Huntington’s, CVD, metabolic conditions, endocrine conditions, autoimmune disease, infections, some cancers
Is suicide common?
Top ten cause of death overall, top 3 in young adults and teens (global issue)
What must a physical do when a patient reveals suicidal ideation?
MUST consider psychiatric consultation and hospitalization
What is unique about the doctor visit time frame of individuals who commit suicide?
Many have visited a physician during the month before they take their lives
How prevalent is suicide among bipolar patients?
COMMON: 25-50% attempt it at least once
What specific population of people are at an increased risk of suicidal thoughts and attempts?
College students
What are some effective suicide interventions?
Restriction of methods of suicide, crisis centers, prevention/treatment of depression and substance abuse, school-based interventions
