Mood disorders Flashcards
What psychiatric symptoms are associated with Lyme disease?
Difficulty concentrating, irritability, and depression - often associated with a flulike illness
Within what time period is depressed mood following a death considered normal bereavement?
Less than 2 months
How common is postpartum blues?
30-75% of women
How long after a stroke is a patient most likely to develop post-stroke depression?
6 months
Is anhedonia a feature of postpartum blues or postpartum depression?
Postpartum depression
What are common features of depressive disorder with a seasonal pattern?
Hypersomnia and hyperphagia
What are the treatments for depressive disorder with a seasonal pattern?
Light therapy and serotonergic agents (usually an SSRI)
What are features of cyclothymic disorder?
Recurrent periods of mild depression alternating with periods of hypomania. This pattern must be present for at least 2 years. Symptom free intervals should not be longer than 2 months.
What are the most common complaints after ECT?
Headache, nausea, and muscle soreness
What is the time requirement of symptoms for persistent depressive (dysthymic) disorder in adults and adolescents?
Adults: 2 years
Adolescents: 1 year
What are the relative contraindications to ECT therapy?
Very safe procedure with very few relative contraindications - increased intracranial pressure, MI in the past 4 weeks, aneurysm, bleeding disorder, and any disorders that disrupt the blood brain barrier. *Safe in pregnant women.
How is REM sleep affected by depression?
Shortened REM
What brain imaging study is characteristic of depression?
Decreased blood flow and metabolism in the frontal lobes on PET scan
What feature of depression is one of the most accurate predictors of suicide?
Hopelessness
What are the features of major depressive disorder with melancholic features?
Anhedonia, lack of reactivity (nothing can make patient feel better), intense guilt, significant weight loss, early morning awakening, and psychomotor retardation.
What is double depression?
When a major depressive episode develops in a patient with dysthymic disorder
What are the characteristics of MDD with atypical features?
Mood reactivity (pleasurable events may temporarily improve mood), self-pity, excessive sensitivity to rejection, reversed diurnal mood fluctuations ( patients feel better in the morning), and reversed vegetative symptoms (increased appetite and increased sleep).
What months of the year is a manic episode more likely to present?
Summer months - associated with increased sunlight
How is REM sleep affected in major depressive disorder?
See decreased latency of REM
What proportion of school aged children with major depression demonstrate psychotic symptoms?
1/3
What somatic illness should be considered in a middle-aged patient with depression and abdominal pain?
Pancreatic cancer - presents with weight loss, abdominal pain, apathy, decreased energy, lethargy, anhedonia, and depression. Psychiatric symptoms often present before any somatic symptoms so pancreatic cancer should always be considered in middle-aged patients with new onset depression.
What is the relative risk of suicide of a female physician compared with the general female population?
Increased
How long should a patient continue an antidepressant if they respond well after a single major depressive episode?
An additional 4-9 months to prevent relapse
