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mood disorders Flashcards

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1
Q

which mood disorder has worse prognosis, higher suicide rates than MDD, and usually requires hosptialization

A

bipolar I

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2
Q

One more MANIC episodes

Episodes of depression are common but are not necessary for diagnosis.

A

bipolar I

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3
Q

One or more major DEPRESSIVE episodes + at least one hypomanic episode

A

bipolar II

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4
Q

similar to bipolar I but less severe and cause less social impairment

A

bipolar II

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5
Q

what may trigger a manic episode; medications wise

A

antidepressants without mood stabilizers

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6
Q
  • can go days without sleep, very talkactive and loud, socially outgoing, overly self confident, hypersexual, disinhibited
  • difficult to follow thought process, judgement impaired
A

bipolar I

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7
Q

bipolar I tx

  • effective
  • acute mania
  • agitation or psychotic
  • acute depression
  • secondary tx
A

bipolar I tx

  • effective: mood stabilizers
  • acute mania: 2nd gen antipsychotics
  • agitation or psychotic: haldol or benzos
  • acute depression: SSRI or quetiapine; use olanzapine concurrently for depression
  • secondary tx: ECT, MAO-I, TCA
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8
Q

bipolar II does not have what

A

no manic or mixed episodes

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9
Q

tx for bipolar II when pt mainly has depression

A

lithium

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10
Q

which d/o does MDD develop in 10-20% of pts

A

dysthymic d/o

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11
Q

what is dysthymic d/o?

-no what

A

Less severe but longer lasting depression
“bad state of the mind”
- no psychotic, MDE, or manic/hypomanic features

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12
Q

how to dx dysthymic d/o

A

during 2 year period- depressive sx never absent more than 2 months

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13
Q

dysthymic d/o tx
1st line
3 other tx

A
  • *1st line SSRI, 2nd line SNRI, TCA

- psychotherapy

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14
Q

similar to bipolar II but less severe

- 15-20% risk of BPD

A

cyclothymic d/o

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15
Q

pessimism, brooding, loss of interest, decreased productivity, inadequacy feelings, social withdrawal

A

dysthymic d/o

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16
Q

moody, erratic, impulsive, somewhat volatile

A

cyclothymic d/o

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17
Q

cyclothymic d/o tx

A

1st line is mood stabilizers and antimanic drugs

- tx similar to BPD

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18
Q

maladaptive behavior or emotional symptoms that develop in 3 months after a stressful life event and end within 6 months of event

A

adjustment d/o

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19
Q

adolescents: precipitants are parental rejection and divorce, school problems, leaving home
adults: stressors are marital discord, financial difficulties, loss of job, marriage, parenthood, natural disasters, racial/religious persecution

A

adjustment d/o

20
Q

tearfulness, depressed mood, vandalism, reckless driving, truancy, fighting, anxiety

A

adjustment d/o

21
Q

adjustment d/o tx

A

supportive psychotherapy or group therapy

- short term meds for assoc insomnia, anxiety, and depression (not 1st line)

22
Q

For an adjustment disorder to be diagnosed, the following criteria must be met:

A

Having emotional or behavioral symptoms within three months of a specific stressor occurring in life
Experiencing more stress than would normally be expected in response to the stressor
An improvement of symptoms within six months after the stressful event ends
The symptoms are not the result of another diagnosis

23
Q

Loss of pleasure in most or all activities
Failure of reactivity to pleasurable stimuli
Quality of depressed mood more pronounced than that of grief or loss
Worsening of symptoms in the morning hours
Early-morning waking
Psychomotor retardation
Excessive weight loss
Excessive guilt
maybe suicide ideation

A

Melancholic depression

24
Q

Mood reactivity
Significant weight gain or increased appetite – comfort eating
Hypersomnia – excessive sleep or sleepiness
Leaden Paralysis – sensation of heaviness in limbs
Significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection

A

Atypical depression

25
Q

Disturbances of motor behavior and other symptoms
Mute and almost stuporous
Either remains immobile or exhibits purposeless or even bizarre movements – posturing and waxy flexibility – move as if made by wax. Seen in catatonic schizophrenia as well.

A

Catatonic depression – rare but severe

26
Q 
\_\_\_\_ depression
Includes delusions / hallucinations
\_\_\_ depression
Incidence Rate: 10–15% among new mothers
Occurs within one month of delivery
A 
Psychotic depression
Includes delusions / hallucinations
Postpartum depression
Incidence Rate: 10–15% among new mothers
Occurs within one month of delivery
27
Q

50% of hospitalized pts with major depression have this MDD subtype

A

melancholia

28
Q

seasonal affective tx [3]

A

light therapy, buprion, SSRI

29
Q

melancholia tx [2]

A

antidepressants, ECT

30
Q

atypical depression tx [3]

A

MAOI, SSRI, atypicals

31
Q

catatonic depression tx [2/2]

A

both antidepressants and antipsychotics simultaneously

- maybe ECT, benzos

32
Q

psychotic depression tx

  • agitation
  • maintenance
A

agitation: benzos plus antidep
maintenance: antidep, 2nd gen antipsychotics

33
Q

Waxy flexibility should make you think of what two possible diagnosis?

A

Catatonic depression and catatonic schizophrenia

34
Q

Is a major depressive episode necessary for the the diagnosis of bipolar?

A

Not for bipolar I

35
Q

In order to diagnose dysthymic disorder symptoms must occur over what period of time?

A

2 years.

36
Q

Can ECT be used during pregnancy?

elderly?

A

Yes

yes

37
Q

MDD suicide risk and course

A

15%; chronic course with relapses

38
Q

ECT side effects

A

postictal confustion, somatic complaints(HA, nausea, mm soreness, **memory loss(returns to baseline)

39
Q

MDD tx

A

** SSRI 4-6 wks
maintenance: over 6 months
ECT effective, psychotherapy combo

40
Q

MDE dx

A

5 or more depressive signs; 2 week period; changes from previous function
1 symptom of depressed mood or anhedonia
no manic s/s; no result of bereavement

41
Q

manic episode dx

A

abnormal and persistant increased expansive and irritable mood at least 1 week
-3 manic sx(4 if mood is irritable)

42
Q

when to hospitalize manic episode

A

psychotic features; acute mania need to initiate tx

43
Q

what results in severe social and/or occupational dysfunction

A

manic and hypomanic episodes

44
Q

hypomanic episode dx

A

at least 4 days of manic mood;
-3 manic sx(4 if mood is irritable)
no psychotic features

45
Q

mixed episode dx and describe severe sx

A

rapidly alternating moods; symptoms of both manic and depressive at least 1 week
sx severe: marked impairment in occupational or social functioning

46
Q

SSRI first line in what [5]

A

GAD, panic, dysthmic, OCPD, MDD, PTSD

psychology (6 decks)

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