Mood Disorders Flashcards
how long must you have symptoms to be diagnosed with MDD?
2 weeks
how many symptoms must you have to have MDD?
5…
what are the symptoms of MDD?
low mood weight loss or gain fatiigue poor concentration worthlesness/guilt insomnia/hypersomnia suicidal ideation
what is the mnemonic for depressive symptoms?
Sleep disturbance
Iinterest/pleasure reduction
Guilt
Energy loss
Concentration impairment
Appetite changes
Psychomotor changes
Suicidal thoughts
name five predisposing environmental factors for mood disorder
low birth weight childhood illness/abuse unemployment loss of parent social isolation
what is the NT change in depression
decrease in dopamine, NE and serotonin
what is the NT change in Mania?
increase in dopamine, decrease in GABA
what is the NT change in schizophrenia?
increase dopamine and serotonin
what is the NT change in anxiety?
decrease GABA and serotonin, increase NE
what is the median duration of MDD?
20 weeks
what are sleep changes associated with MDD?
difficulty initiating, maintaining sleep or too much sleep
what are EEG changes to sleep with MDD?
very little slow wave sleep, longer REM sleep
what is the mnemonic for risk factors for depression?
SADPERSONS
what does the S stand for in SADPERSONS?
Sex…male
what does the A stand for in SADPERSONS?
Age less than 18 and more than 45
what does the D stand for in SADPERSONS?
Depression
what does the P stand for in SADPERSONS?
Past attempt
what does the E stand for in SADPERSONS?
Etoh or illicit substances
what does the R stand for in SADPERSONS?
rational thinking loss
what does the S stand for in SADPERSONS?
SIngle, widowed, divorced
what does the O stand for in SADPERSONS?
Organized plan
what does the N stand for in SADPERSONS?
No social support
what does the S stand for in SADPERSONS?
Stated intent
what is it called when a mood disorder starts due to substance use?
substance induces mood disorder
do Benzos cause depression or mania?
depression
do alcohol cause depression or mania?
depression
do interferon-alpha cause depression or mania?
depression
do corticosteroids cause depression or mania?
both
what are the diagnostic criteria for Bipolar I disorder?
one week of elevated expansive or irritable mood with increased activity energy with three of these: increased self esteem decreased need for sleep increased talking racing thoughts distractible
what is the mnemonic for Bipolar I symptoms?
Distracible
Impulsive
Grandiosity
Flight of ideas
Activity increased
Sleep decreased
Talkativeness
what is the difficulty with diagnosing bipolar I disorder?
over 50% of patients present in depressed mood on first visit
in addition to a manic episode what must you have for bipolar I?
depressive episode
what is diagnostic criteria for bipolar II disorder?
Major depressive episode and hypomania…no manic episode allowed
what other psych illness is bipolar II disorder associated with most commonly?
anxiety
what are people with bipolar at a really elevated risk for compared to general population?
SUICIDE
when do mood disorders lead to psychotic features?
only at the highest and lowest points…major depressive and manic episodes
what is the diagnostic criteria for PDD?
less symptoms and milder than MDD..but chronic depressive symtpoms
is PDD worse or better with symptoms that MDD?
it is not as bad
what is double depression?
when a patient with PDD develops a major depressive episode…84% risk of this happening with PDD
what is Rx for double depression and PDD?
antidepressants and psychotherapy
what is cyclothymia?
changes between levels of hypomania and and periods of depressive symptoms
how long does cyclothymia have to last?
for at least 2 years
what is bipolar NOS?
rapid alterations between manic symptoms and depressive symptoms that meet symptom threshold criteria but not duration for manic, hypomanic, or major depressive episodes
why is bipolar NOS not able to be considered a manic, hypomanic or major depressive episode?
it is short lasting…like a couple days
what is the therapy for seasonal affective disorder?
light therapy
what is mood reactivity in atypical depression?
they are able to respond with better mood to positive events
what are the reversed vegetative symptoms in atypical depression?
hypersomnia and hyperphagia
does normal depression feel worse at night or in the morning?
in the morning for normal
doe atypical depression feel worse at night or in the morning?
at night for atypical
what can PPD cause between mother and child?
difficulty in bonding in the early years…this can lead to negatively impact of a childs emotional and cognitive development
what does the presence of PPD have an odd assocations?
PTSD and trauma
what are risk factors for PPD during pregnancy>
stressful life event, depression/anxiety symptoms and inadequate social support
what is a biological issue that causes risk for PPD?
thyroid dysfunction
what is the risk factor for age with PPD?
age under 18 yo
what is risk factor for breastfeeding with PPD?
early weening of breastfeeding
what are the postpartum blues?
2-3 days of more crying emotional liability and irritability, less sleep and appetite disturbances
when does postpartum blues occur? how long does it last?
2-3 days after birth and lasts 2-3 days
what is postpartum blues due to?
abrupt hormone withdrawal…progesterone gone
what is diagnostic criteria for PPD?
same as MDD but must be within first month post delivery
what is Rx for PPD?
antidepressants and CBT
is the HPA axis over or underreactive during pregnancy?
overreactive
is the HPA axis over or under active during postpartum and PPD?
under active
what is postpartum psychosis?
2-4 weeks post delivery…confused thinking, mood swings, delusions, paranoia poor judgement and impaired functioning
how soon does postpartum psychosis occur?
2-4 weeks post delivery
who is postpartum psychosis most common in?
mothers with bipolar disorder
