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Behavioral Medicine > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Is depression and bipolar disorder order more common in men or women?

A

Women

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2
Q

Which has the earliest onset?

A. Depression
B. Persistent Depressive Disorder
C. Bipolar

A

C. Bipolar (25 y.o.)

Depression (32 y.o.)
PDD (31 y.o.)

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3
Q

When working up a patient for a suspected mood disorder is it useful to use the SIGECAPS and PHQ-9 questionnaires?

A

Yes

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4
Q

For a patient to be diagnosed with major depressive disorder (MDD)….

They must have 5 symptoms of depression for at least how long?

What needs to be excluded?

These symptoms need to have a significance impact on what?

A

5 Sx over 2 WEEKS

Exclude…..
Underlying Illness
Substance Abuse

The Sx must have a significant impact on the patient’s ADLs

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5
Q

For a patient to be diagnosed with persistent depressive disorder (PDD)….

They must have 2 or more symptoms of depression for at least how long?

A

2 Years

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6
Q

Are patients with MDD likely to verbalize depressive symptoms?

A

No

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7
Q

T/F: The elderly with MDD will often manifest new somatic complaints

A

True

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8
Q

What is most likely the biggest complaint in a patient with MDD?

A

Loss of interest

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9
Q

_______ (initial/middle/terminal) insomnia is described as difficulty falling asleep as well as tossing and turning

A

Initial Insomnia

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10
Q

_______ (initial/middle/terminal) insomnia is described as awakening in the middle of the night, being up for a few hours, and falling back to sleep

A

Middle Insomnia

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11
Q

_______ (initial/middle/terminal) insomnia is described as early morning awakening with the inability to fall back asleep.

A

Terminal Insomnia

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12
Q

What medication classes are first line for MDD treatment?

A

SSRIs…..

fluoxetine (PROZAC), 20-80 mg/d
citalopram (CELEXA), 20-40 mg/d
escitalopram (LEXAPRO), 10-20 mg/d
sertraline (ZOLOFT), 50-200 mg/d
paroxetine (PAXIL), 20-50 mg/d

SNRIs……

venlafaxine XR (EFFEXOR XR), 37.5-225 mg/d
duloxetine (CYMBALTA), 30-120 mg/d

TCAs…..

amitriptyline
nortriptyline
imipramine
desipramine

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13
Q

If a patient is started on a SSRI, SNRI, or TCA for MDD…..

How long may it take for the medication to take effect?

How long should you continue the medication prior to titrating the dose?

A

May show improvement in 1-2 weeks

Need to wait 4-8 weeks before adjusting the dose

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14
Q

T/F: Electroconvulsive therapy is used in MDD treatment

A

True

It does have a higher remission and relapse rate

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15
Q

About __% of patients with MDD will develop chronic depression

A

20%

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16
Q

About __-___% of patients hospitalized for depression will successfully take their own life

A

10-15%

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17
Q

What is the recommended treatment of light-to-moderate MDD?

A

Psychotherapy

+/- medication depending on patient preference

18
Q

What is the recommended treatment of moderate-to-severe MDD?

A

Medication +/-psychotherapy

ECT can be considered

19
Q

What is the GOLD STANDARD treatment for depression WITH psychotic features?

A

ECT

20
Q

When working up a patient with suspected mania, what questionnaire should you use in combination with the PHQ-9 and SIGECAPS?

A

DIGFAST

21
Q

______ is described as abnormal persistent elevated, expansive or irritable mood lasting at least 4 days (< 7 days).

A

Hypomania

22
Q

Would you expect to see delusions or hallucinations in patients with hypomanis?

A

No

23
Q

Are hypomanic patients often hospitalized?

A

No

24
Q

How is Bipolar 1 defined?

How long are the intervals between episodes?

A

At least 1 manic episode and usually recurrent depression and mania

Intervals between episodes can be anywhere from months to years

25
Q

How is Bipolar 2 described?

Do these patient have a history of manic episodes in the past?

A

One or more major depressive episodes and at least one episode of hypomania

These patients have NO prior episodes of mania

26
Q

___% of patients with a single manic episode will have recurrent mood episodes

A

90%

27
Q

__-__% of Bipolar 1 patients have a family history of MDD

A

60-65%

28
Q

T/F: Bipolar Disorder is more common in women than in men

A

False

There is an equal prevalence in both men and women

29
Q

What is Bipolar 2 often diagnosed as first?

What may lead to a diagnosis of Bipolar 2

A

MDD

Depressed state followed by and episode of hypomania

(*remember bipolar 2 patients have no history of manic episodes)

30
Q

Bipolar 2 patients may have 4 or more mood changes….

What is this concerned as?

A

Rapid Cycling

31
Q

If a patient diagnosed with Bipolar 2 does have a manic episode what happens to their diagnosis?

A

Changes to Bipolar 1

32
Q

What are pharmacological management options for acute mania?

A 
Lithium
Divalproex
Olanzaprine
Risperidone
Quetiapine
Aripiprazole
Ziprasidone
33
Q

What are pharmacological management options for an acute major depressive episode?

A

Lithium
Lamotrigine
Quetiapine

34
Q

What are pharmacological management options for bipolar disorder maintenance?

A 
Lithium
Lamotrigine
Divalproex
Olanzaprine
Risperidone
Quetiapine
Aripiprazole
35
Q

Why is important to follow a manic bipolar patient closely?

A

Depression may follow closely when the mania breaks

36
Q

T/F: Routine and good sleep habits are important for preventing relapse in a patient diagnosed as bipolar

A

True

37
Q

Is psychotherapy beneficial for bipolar patients in a manic state?

A

No

But this should be used when they’re in a depressive state

38
Q

Cyclothymic disorder is the mildest form of bipolar disorder……

Do these patients often have impairment in their ADLs?

Do these patients exhibit psychotic symptoms?

Are these patients asymptomatic for longer than 2 months?

A

No to all three

39
Q

Is persistent depressive disorder (Dysthymia) more common in men or women?

A

Women

40
Q

For a patient to be diagnosed with persistent depressive disorder (Dysthymia)…..

They must have at least two of what six symptoms?

A 
Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration/difficulty making decisions
Feelings of hopelessness
41
Q

How is persistent depressive disorder (Dysthymia) managed?

A

Antidepressants

Psychotherapy

Behavioral Medicine (16 decks)

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