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mood disorders Flashcards

1
Q

etiology of major depression

A

no clear cause, its complex and multifactorial

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2
Q

are mood disorders more common in males or females?

A

females

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3
Q

4 types of mood disorders

A

Major Depressive Disorder (MDD)
Persistent Depressive Disorder
Premenstrual Dysphoric Disorder (PMDD)
Bipolar Disorder

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4
Q

3 types of bipolar disorder

A

Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder

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5
Q

what age group is most likely to have major depression?

A

baby boomers

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6
Q

what is anhedonia?

A

don’t enjoy the things you usually enjoy

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7
Q

who is more likely to experience irritability with depression? men or women?

A

often men

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8
Q

once someone has a major depressive episode is it more likely they will have another?

A

YES!

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9
Q

changes in sleeping and eating with major depression

A

more about CHANGE IN BASELINE - sleep more or less, eat more or less

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10
Q

4 sources of misDx of major depression (4 reasons it may be ignored)

A
  1. its a Sign of “normal” aging in elderly
  2. Cognitive impairment in elderly often misdiagnosed as dementia
  3. “Normal” following stressful events
  4. Comorbid gen med condition that “causes” symptoms of depression may lead to discounting the depressive symptoms
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11
Q

what are the 4 categories of symptoms for major depressive disorder?

A
  1. Affective- irritable, angry, flat
  2. Cognitive triad
  3. Behavioral- poor hygeine, isolated self, etc.
  4. Physiological
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12
Q

what is the “cognitive triad” ?

A

Cognitive triad: self, outside world, future

confused easily, lack of self worth, etc.

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13
Q

define: major depressive disorder- single episode

A
  • Presence of single major dep episode
  • Not better accounted for by schizoaffective d/o
  • There has never been a manic episode, mixed episode, or hypomanic episode (this would be bipolar disorder)
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14
Q

define: major depressive disorder- recurrent

A

Presence of two or more MDEs, at least 2 months apart

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15
Q

what are the 3 various “specifiers” for major depressive disorder single, recurrent ?

A

With peripartum onset, with seasonal pattern, with psychotic features among others

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16
Q

major depressive episode DSM 5 dx

A

Five or more of the following symptoms present during same 2 week period, and represent a change from previous functioning (must have 1 or 2).

  • depressed mood
  • diminished interest
  • change in weight
  • change in sleep
  • pyschomotor agitation or retardation
  • fatigue
  • feeling worthless
  • decreased ability to concentrate
  • recurrent thoughts of death
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17
Q

for DSM5 Dx: Symptoms MUST cause clinically significant in _______ or _______ social, occupational, other areas of functioning

A

distress or impairment

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18
Q

for DSM 5 Dx: symptoms must NOT be caused by…

A

substance or general medical condition

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19
Q

what defines persistent depressive disorder?

A

like “major depression light”: lasts longer but symptoms aren’t as severe
-Depressed mood for MOST of the day, MORE DAYS than not, for at least 2 YEARS (1 yr for children & adolescents)

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20
Q

what is dysthymia?

A

another name for persistent depressive disorder

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21
Q

persistent depressive disorder: Never without symptoms for more than____ at a time

A

2 months

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22
Q

what is premenstrual dysmorphic disorder?

A

at least 5 key symptoms present in the final week before menses. They improve after onset of menses, and gone the week after menses.

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23
Q

what is lability?

A

rapidly changing emotions

occurs with premenstrual dysmorphic disorder

24
Q

major depression - must be around for how long? what about persistent depressive disorder?

A

major- 2 weeks

persistent- 2 years

25
Q

some people with depression may present only with what type of symptoms?

A

physical

i.e. HA, backache, insomnia, dizzy, etc.

26
Q

what is somatic symptom disorder?

A

physical symptoms without physiological basis that can look like depression but isnt

27
Q

is txt for depression effective?

A

yes! 70-90%

28
Q

3 types of pharmacotherapy for depression?

A
  1. Antidepressants for MDD, Dysthymia
    SSRI (selective serotonin reuptake inhibitor)
  2. Other first-line agents (Wellbutrin, Remeron, Serzone, Effexor)
  3. Tricyclics (side effects, overdose potential)
29
Q

what is the most effective txt for depression?

A

cognitive behavioral therapy

(but works best in combo with meds)

30
Q

what are the types of procedural txt for depression?

A

ECT, vagus nerve stimulation, light therapy

31
Q

what is ECT?

A

anesthetized with an intravenous injection of a barbiturate or other anesthetic
-An electrical current is then passed through the brain, inducing a grand mal seizure

32
Q

what is ECT and vagus stim. used for?

A

treatment-resistant depression

33
Q

what is light therapy used for?

A

seasonal depression

34
Q

bipolar 1 and 2 include different combos of three types of episodes

A

major depressive
manic
hypomanic

35
Q

what defines a manic episode?

A

Distinct period of abnormally and persistently elevated, expansive, or irritable mood, and persistently increased goal-directed activity or energy (AT LEAST 1 WEEK)

36
Q

Dx of manic episode, must have 3 or more of the following symptoms… AND notable change from previous behavior

A
  • inflated self esteem
  • decr. need for sleep
  • talkative
  • flight of ideas
  • distractible
  • goal-directed activity OR pyschomotor agitation
  • dangerous activities (potential for painful consequence)
37
Q

what defines a hypomanic episode?

A

Present for at least 4 days

  • Must be a change from usual behavior
  • DOES NOT CAUSE marked impairment in social or occupational functioning,
38
Q

what defines bipolar 1 disorder

A

Must have at least 1 Manic Episode
May have Major Depressive Episodes
May have Hypomanic Episodes

39
Q

what defines bipolar 2 disorder

A

Recurrent Major Depressive Episodes with Hypomanic Episodes

has never been a Manic Episode

40
Q

what is the most over-diagnosed pysch disorder?

A

bipolar disorder

41
Q

avg age of onset for bipolar disorder

42
Q

bipolar disorders are what type of disorders ? (acute or chronic)

43
Q

what is cyclothymic disorder?

A

Hypomanic symptoms (don’t meet criteria for hypomanic episode) AND depressive symptoms (don’t meet criteria for MDE) for at least 2 years

44
Q

4 common specifiers for cyclothymic disorder

A
  1. with rapid cycling (4 episodes in a year)
  2. with psychotic features (delusion, hallucination)
  3. with anxious distress
  4. with seasonal pattern
45
Q

3 types of psychopharmacology for bipolar disorder

A
  1. Mood stabilizers
  2. Anticonvulsant medications if don’t respond to mood stabilizers
  3. Antipsychotics if psychotic symptoms present
46
Q

2 types of pyschotherapy txt for bipolar disorder

A

Usually cognitive-behavioral

Family therapy

47
Q

why do men often have more successful suicide attempts?

A

they use guns or other more lethal methods

48
Q

men or women attempt suicide more?

49
Q

successful suicide without ____ or _____ is rare

A

alcohol/drug use

50
Q

when is suicide at highest risk?

A

right after starting treatment- you get enough clarity in thinking to begin making a plan

51
Q

5 parts of assessing lethality of suicide attempt

A 
Plan
Time period
Method (and availability)
Prior attempts
Substance abuse
52
Q

Bipolar II disorder is characterized by recurrent Major Depressive episodes with ___________ episodes.

53
Q

Bipolar I disorder is characterized by recurrent Major Depressive episodes with ___________ episodes.

54
Q

Feelings of depression and hopelessness fall into which category of depressive symptoms?

55
Q

affect is the feelings as cognitive is to _____

clin med (88 decks)

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