Mood Disorders Flashcards

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1
Q

By the numbers

A

Major depression more in women
Bipolar is equal
MD leading cause of disability ages 15-44

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2
Q

Development of MD

A

HC, Limbic, amygdala, anterior cingulate, hypothalamic pituitary

Complex interactions between regions and NTs coupled with genetics and environmental factors lead to development

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3
Q

MD and suicide

A

Most contemplate

10-15% die

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4
Q

Major depression guidelines

A

5 of following symptoms during same 2 week period and represent change…at least 1 is either depressed moodd or loss of interest/pleasure

Depressed mood most of day everyday
Markedly dmiinished interest in all or almost all activities nearly everyday
Weight loss when not dieting or decrease appetite
Insomnia or hypersomnia
Psychomotor agitation/retardation
Fatigure/loss of energy
Feeling or worthlessness or guilt
Diminished ability to think or concentrate/indecisiveness
Recurrent throughts of death/suicidal plan

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5
Q

Other MD requirments

A

Symptoms cause clinically significant distress or impairment
Episdoe not attributable to substnace or other condition
Occurrence is not better explained by another mental disorder
Never been manic or hypomanic episode

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6
Q

Anxious distress
Mixed features
Seasonal pattern

A

Feeling tense/restless/difficulty conentrating and fear something awful may happen

Manic/hypomanic symptoms present nearly every day during episode

Regular relationship between onset and time or year

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7
Q

Melancholic
Atypica
Peri-partum

A
Loss of pleasure 
Profound despondency, despair.
Worse in morning and early morning wakening 
Psychomotor agitation/reatardation
Guilt 

Modd reactivity/weight gain or increase in appetite/hypersomnia/leaden paralysis

During pregnancy or in 4 week following…emergency

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8
Q

Grief vs MD

A

Grief - empitness and loss
MD - presistent depressed mood and inability to anticipate happniess and pleasure

Dysphoria in grief will decrease

Grief thoughts normally associated with lost loved one

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9
Q

PDD

A

Depressed mood for most of the day for more days than not as indicated by subjective account for at least 2 years

2 or more of following 
poor appitaite or overeating
Insomnia/hypersomnia
Low energy
Low self-esteem
Poor concentration or decision making
Hopelessness

Symptoms not from drugs or other

CSI

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10
Q

Dysthymia (persistent) vs. major depression

A

Dysthymia - 2 weeks, depressed plus 2 others, more cognitive symptoms, mild onset may be followed by major after 2 years

MD - 2 weeks, depressed plus 5 other sx, more vegetative sx, more severe symptoms

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11
Q

Manic episode

A

Lasting at least one week

3 of following during increased mood and energy
Inflated self-esteem/grandiosity
Decreased need for sleep
More talkataive
Flighjt of ideas
Distractibility
Increase goal-directed/pschomotor agitation
Excessive risky behaviors 

Mood disturbance causes CSI or hospitalization

Not from drugs

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12
Q

Hypomanic episode

A

4 days
Same symptoms (3 of them)
Associated iwht change in functioning that is uncharactersitic
Disturbance is observable
Episode NOT severe neough to cause CSI or hospitalization
Not a drug

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13
Q

Bipolar 1 v.s 2

A

1 - one or more manic episodes

2 - one or more hypomanic episodes but there has never been a manic…presence of one or major MD episodes

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14
Q

Cyclothymic disorders

A

For at least 2 years, numerous periods iwth hypomanic symptoms that do not meet criteria for hypomanic episode and numerous with depressive that don’t meet MD
Hypoamnic and depressive periods present for at least 1/2 the time and not been w/out symptoms for more than 2 months

Cause CSI

Not drug

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15
Q

Substance use disorders

A

Prevalence of depression higher in active drinkers

Important to ID which came first

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16
Q

Course major depression

A

Longer is has been present, more likely to persist

On average, every 5 years

As more episodes happen, time between them shortens and severity increases

Untreated MD lasts 6-12 while treated is 3

MD tends to be chornic

Men are more likely chornic

17
Q

Good outcome in MD

A

Mild, absence of psych symptoms, friendships during adolesnce, family, no other mental dz, no fam hisotry, advanced age

18
Q

Course bipolar disorder

A

Average age of onset is 6 y/o
Episodes last 5-10 weeks
Fewer than 1/3 remain euthymic for a year

19
Q

Tx of major

A

Mild - pharmaco/psycho therapy
Moderate to severe- combiination

May need hospitalization

Limit MAOIs to those who have failed others

Full effect may take 4-8 weeks

Continue for 6-12 months after remission

20
Q

ECT

A

When patient is unresponsive to antidepressants and cannot tolerate side effects OR when situation is so severe that rapid improvement needed

Bifrontotemporal placement

Highest rate of response

Can be done on pregnant

Extremely effective with 6-12 txs

21
Q

Tx of bipolar

A

Lithium for acute manic episodes

Anticonvulsants may helps

Atypical antipsychotics may help