Mood Disorders Flashcards
What was Dissociative indentity disorder formally known as??
Multiple personality disorder
What is Dissociative identity disorder?
Presence of 2 or more distinct identities or personality states
Who is Dissociative identity disorder MC in?
Women
What is Dissociative identity disorder assoc w/?
History of sexual abuse
What is Depersonalization disorder?
Persistent feelings of detachemtn or estrangement from one’s own body, a social situation or the environment
What is Dissociative fugue?
Abrupt change in geographic locations w/ inability to recall the past, confusions about personal identity or assumption of new identity
What are Dissociative fugue assoc w/?
Traumatic circumstances (natural disasters, wartime, trauma0
What does Dissociative fugue lead to?
Significant distress or impairment
What is Dissociative fugue NOT the result of?
Substance abuse or general medical cond
What is Mood disorder characterized by?
ABN range of moods or internal emotional states & loss of control over them
What does the severity of Mood disorders cause?
Distress & impairment in social & occupational functioning
What does Mood disorders include?
- Major depressive disorder
- Bipolar disorder
- Dysthymic disorder
- Cyclothymic disorder
What may be present in Mood disorders?
Psychotic features (delusions or hallucinations)
What is a Manic episode?
Distinct period of ABN & persistenly elevated, expansive or irritable mood & ABN & persistently inc activity or energy lasting at least 1 week
At least 3 of the following must be present to dx a manic episode
- Distractibility
- Irresponsibility
- Grandiosity
- Flight of ideas
- Inc in goal-directed activity/sphycomotor Agitation
- Talkativeness or pressured speech
What is a Hypomanic episode?
Like manic episode except mood disturbance is not severe enough to cause marked impairment in social &/or occupational functioning or to necessitate hospitilization. No psychotic features
What is Bipolar disorder defined by?
Presence of at least 1 manic (bipolar I) or hypomanic (bipolar II) episode
What sx evetually occur in Bipolar disorder?
Depressive sx
Between bipolar episodes pt’s ___ & ___ usually return to normal.
Mood & functioning
Use of ____ can lead to inc mania.
Antidepressants
What do Bipolar pts have an inc risk of?
Suicide
What is the tx for Bipolar disorder?
- Mood stabilizers
- Atypical antipsychotics
What is Cyclothymic disorder?
Dysthymia & hypomania; milder form of bipolar disorder lasting at least 2 years
What is major depressive disorder?
Self-limited disorder, w/ major depressive episodes usually lasting 6-12 months
Episodes of major depressive disorder are characterized by at least 5 of the following sx for 2 or more weeks:
- Sleep disturbance
- Loss of Interest
- Guilt or feelings of worthlessness
- Loss of Energy
- Loss of Consciousness
- Appetite/wt changes
- Psychomotor retardation or agitation
- Suicidal ideations
- Depressed mood
What is Dysthymia?
Milder form of depression lasting at least 2 years
What is Seasonal affective disorder?
Sx assoc w/ winter season; improves in response to full-specturm bright-light exposure
What is Atypical depression?
Differs from classical forms of depression
What is Atypical depression characterized by?
- Mood reactivity
- “Reversed” vegetative sx
- Leaden paralysis
- Long-standing interpersonal rejection sensitivity
What is mood reactivity?
Being able to experience improved mood in response to postive events
What are “reversed” vegetative sx?
Hypersomnia & wt gain
What is leaden paralysis?
Heaving feeling in arms & legs
What is the MC subtype of depression?
Atypical depression
What is the tx of Atypical depression?
MAO inhibitors & SSRIs
What is the incidence rate of Maternal (postpartum) “blues”?
50-85%
What is Maternal “blues” characterized by?
Depressed affect, tearfulness & fatigue starting 2-3 days after delivery
How long does Maternal “blues” last?
Usually resolves w/in 10-14 days
What is the tx for Maternal blues?
Supportive & follow up for postpartum depression
What is the incidence rate of postpartum depression?
10-15%
What is postpartum depression characterized by?
Depressed affect, anxiety & poor concentration stating w/in 4 weeks of delivery
How long does postpartum depression last?
2 weeks to a year or more
What is the tx for postpartum depression?
Antidepressants & psychotherapy
What is the incidence of postpartum psychosis?
0.1-0.2%
What are the characteristics of Postpartum psychosis?
- Delusions
- Hallucinations
- Confusion
- Unusual behavior
- Possible homicidal/suicidal ideations or attempts
How long does Postpartum psychosis last?
Days to 4-6 weeks
What is the tx for Postpartum psychosis?
- Antipsychotics
- Antidepressants
- Possible inpatient hospitalization
What is Electroconvulsive therapy?
Tx option for major depressive disorder refractory to other tx & for pregnant women w/ major depressive disorder
What is Electoconvulsive therapy also considered for sue in?
- Immediat response necessary (suicide)
- Depression w/ pschotic features
- Catatonia
What does Electroconvulsive therapy produce?
Painless seizures in an anesthetized pt
What are the major adverse effects of Electroconvulsive therapy?
Disorentation & temporary anterograde/retrograde amnesia usually fully resolving in 6 months
What are the RF for suicide completion (SAD PERSONS)?
- Sex (male)
- Age (teenager or elderly)
- Depression
- Preveious attempt
- Ethanol or drug use
- Loss of Rational thinking
- Sickness (medical illness or >3 Rx)
- Organized plan
- No spouse
- Social support lacking
Who tries to commit suicide more often?
Women
Who is succeeds more often in commiting suicide?
Men
What is anxiety disorder?
Inappropriate experience of fear/worry & its physical manifestations when the source of the fear/worry is eitehr not real or insufficent to acount for the severity of sx
Anxiety disorder sx interfere w/ ____ ____.
Daily functioning
What is the lifetime prevelance of anxiety disorder?
30% in women & 19% in men
What does anxiety disorder include?
- Panic disorder
- Phobias
- OCD
- PTSD
- Generalized anxiety disorder
Panic disorder is defined by recurrent episodes of intense fear & discomfort peaking in 10 min w/ at least 4 of the following:
- Palpitations
- Parasthesias
- Abd distress
- Nausea
- Intense fear of dying or losing control
- Light-headedness
- Chest pain
- Chills
- Choking
- Disconnections
- Sweating
- Shaking
- SOB
What is the cause of Panic disorder?
Strong genetic component
What is the tx for Panic disorder?
- Cognitive behavior therapy (CBT)
- SSRIs
- Venlafaxine
- Benzodiazepines
What is Panic disorder assoc w/?
Persistent fear of having another attack
What are the sx of Panic disorder?
Systemic manifestations of fear
What is Sepcific phobia?
Fear that is excessive or unreasonable & interferes w/ normal function. Person realizes fear is excessive
What is specific phobia caused by?
Presence or anticipation of specific object or situation
How is specific phobia tx?
Systemic desensitization
What is Social phobia (social anxiety disorder)?
Exaggerated fear of embarrassment in social situation
What is the tx for Social phobia?
SSRI
What is Obsessive-compulsive disorder?
Recurring intrusive throughts, feelings or sensations that cause severe distress
How is OCD relieved?
By performance of repetitive actions (compulsions)
What is Ego dystonic?
Behavior inconsistent w/ one’s own beliefs & attitudes
What is OCD assoc w/?
Tourette’s disorder
What is the tx for OCD?
SSRIs & clomipramine
What is Post-traumatic stress disorder (PTSD)?
Persistent reexperiencing of a previous traumatic event
What may be involved w/ PTSD?
- Nightmares or flashbacks
- Intense fear
- Hopelessness
- Horror
What does PTSD lead to?
Avoidance of stimuli assoc w/ the trauma persistently inc arousal
What is the duration of PTSD?
Disturbance lasts >1 mo w/ onset of sx begining anytime after event & causes significant distress &/or impaired functioning
What is the tx of PTSD?
Psychotherapy & SSRIs
What is the duration of Acute stress disorder?
Lasts b/w 2 days & 1 month
What is Generalized anxiety disorder?
Pattern of uncontrollable anxiety for at least 6 mo that is unrelated to a specific person, situation or event
What is Generalized anxiety disorder assoc w/?
- Sleep disturbance
- Fatigue
- GI disturbance
- Difficulty concentrating
What is the tx for generalized anxiety disorder?
SSRIs & SNRIs
What is Adjustment disorder?
Emotional sx causing impairment following an indentifiable psychosocial stressor & lasting <6mo
What is Malingering?
Pt consciously fakes or claims to have a disorder in order to attain a specific 2° gain
What do pt w/ Malingering have poor compliance w/?
Tx or follow-up of dx tests
When do complaints cease in malingering?
Cease after gain
What is Factitious disorder?
Pt consciously creates physical &/or psychological sx in order to assume “sick role” & to get medical attention
What is Muchausen’s synd?
Chronic factitious disorder w/ predominatly physcial signs & sx
What is Muchausen’s synd characterized by?
Hx of multiple hospital admissions & willingness to receive invasive procedures
What is Munchausen’s synd by proxy?
When illness in a child or elderly pt is cause by the caregiver. Form of child/elder abuse
What are Somatoform disorders?
Category of disorders characterized by physical sx w/ no indentifiable physical cause
What are unconscious drives of Somatoform disorders?
Illness production & motivation
What is Somatization disorder?
Variety of complaints in multiple organ systems over a period of years developing before age 30 years
What is Conversion?
Sudden loss of sensory or motor function often following an acute stressor; pt is aware of but sometimes indiff toward sx
Who is conversion MC in?
- Females
- Adolescents
- Young adults
What is Hypochondriasis?
Preoccupation w/ & fear of having a serious illness despite medical evaluation & reassurance
What is Body dysmorphic disorder?
Preoccupation w/ minor or imagined defect in appearance, l/t significant emotional distress or impaired function
What do pts w/ body dysmophic disorder seek?
Repeated cosmetic surgery
What is Pain disorder?
Prolonged pain w/ no physical findings
What is the predominant focus of clinical presentation of pain disorder?
Pain
Psychological factors play an important role in Pain disorder:
Severity, exacerbation or maintenance of the pain