Mood disorders Flashcards
what are the mood disorders
- Major Depressive Disorder
- Bipolar I Disorder
- Bipolar II Disorder
- Persistent Depressant Disorder (Dysthymic disorder)
- Cyclothymic disorder
- Anxiety disorders
- Obsessive-Compulsive and related disorders
- Trauma and Stressor Related Disorders
Gender for depression
more females
Neurotransmitters and depression
- NE: down regulated beta receptors; adrenergic function abnormal in depression
- Dopamine decreased
- SSRIs proved effective as anti-depressants . . serotonin
Dopamine in Mania?
increased
Time frame needed for major depressive disorder?
2 week period .. . all criteria on slide 8
criteria for Manic Episode
- Abnormally and persistently elevated, expansive, or irritable mood lasting AT LEAST 1 WEEK with at least 3 of following:
- Inflated self-esteem and Grandiosity
- Decreased need for sleep . . don’t feel tired
- More talkative (pressured/push of speech)
- Flight of ideas/Racing thoughts
- Distractibility
- Increased Goal-oriented behavior
- Excessive involvement in pleasurable activities
- Risk taking
Describe a Hypomanic episode
- Similar to manic but less severe
- only need 4 days and no psychotic features
- no social/occupational impairment
side effect for ECT
short term memory loss
Time frame criteria for persistent depressive disorder (Dysthymia)
- Depressed mood most of day for at least 2 years in adults and 1 year for children but not severe enough for major depressive disorder
- During 2 years, cannot be w/o sx for >2months at a time
Describe Bipolar I disorder
- single manic episode is necessary to diagnose (patients only need one “pole” of the bipolar for this diagnosis)
- At least one manic or mixed episode
Describe Bipolar II disorder
-Patients have had at least one major depressive and one hypomanic episode in the absence of any manic or mixed episodes
1st line choice for treating bipolar disorder
-mood stabilizers: Lithium and valproic acid
what do you need to watch in a pt on lithium
- kidney and thyroid function
- narrow therapeutic index
Describe Cyclothymic disorder
- Characterized as dysthymic disorder with intermittent hypomanic periods
- Patient who, over the last 2 years (1 year for children), experiences repeated episodes of hypomania and depression (not severe enough to meet criteria for major depressive disorder)
Describe a generalized anxiety disorder
- involves worry about actual circumstances, events, or conflicts
- often accompanies panic anxiety
- Symptoms of generalized anxiety fluctuate more than those of panic anxiety
Categories of Anxiety
- Separation anxiety
- Panic disorder
- Agoraphobia
- Generalized anxiety disorder
- Obsessive-Compulsive disorder
- Specific phobias/social phobias
- Posttraumatic stress disorder
Criteria for Panic disorder
- Recurrent unexpected panic attacks
- at least one attack followed by 1 month or more of: persistent concern about additional attacks, Worry about implications of the attack or its consequences (losing control, heart attack), significant change in behavior related to the attacks
Definition of Panic attack
-a discrete period of intense fear or discomfort, in which four or more of the following developed abruptly and reached peak within 10 minutes and usually last <25 minutes . . . bullet points on slide 31
What is Agoraphobia
- Anxiety about being in situations from which escape might be difficult or embarrassing or for which help may not be available
- Ex: being away from home, sitting in middle row of theater seats, being in elevator, traveling on a plane
- Associated with panic disorder
social Anxiety disorder
- > 6 months
- persistent fear of one or more social or performance situations . .could be scrutiny
- they recognize the fear is unreasonable
Generalized Anxiety Disorder
-Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, for most of the day about a number of event or activities
-hard to control worry
-
Obsessive Compulsive disorders
-obsessions and compulsions caused marked distress, are time consuming (>1 hour/day) and interfere with functioning
what are the different types of obsessive-compulsive disorder?
- Hoarding disorder
- Trichotillomania (hair pulling)
- Excoriation Disorder (skin picking)
- Substance medication induced
Difference b/t OCD and OCPD (personality disorder)
- OCPD: ego syntonic . . they don’t perceive they have a problem
- OCD: ego-dystonic . . they know their compulsions and obsessions are not reasonable
time from for posttraumatic stress disorder
more than 1 month
Treatment for Posttraumatic stress disorder
- SSRIs
- Cognitive processing therapy
- Increased risk for substance abuse: avoid Benzos
