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Mood disorders Flashcards

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1
Q

distinct episodes of time in which some abnormal mood is present include: depression, mania and hypomania

A

mood episodes

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2
Q

defined by patterns of mood episodes include MDD, Bipolar I/II, persistent depressive disorder, cyclothymic disorder

A

mood disorder

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3
Q

when patients have delusions and hallucinations due to underlying mood disorder, they are usually mood-congruent. For example:

  1. depression causes psychotic themes of
  2. mania causes psychotic themes of
A
  1. depression causes psychotic themes of paranoia and worthlessness
  2. mania causes psychotic themes of grandiosity and invincibility
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4
Q

Sxs of major depression are:

A

SIG E. CAPS

  • sleep
  • interest
  • guilt
  • energy
  • concentration
  • appetite
  • psychomotor activity
  • suicidal ideation
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5
Q

a manic episode is a psychiatric emergency

A

yep– sev. impaired judgment can make patients dangerous to self and others

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6
Q

MDD diagnosed by DSM-5 crit.

A

at least five out of “SIG E. CAPS” for 2-weeks period

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7
Q

sxs of Mania

A

DIG FAST

  • distractibility
  • insomnia/ impulsive behavior
  • grandiosity
  • flight of ideas/racing thoughts
  • activity/agitation
  • speech/pressured
  • thoughtlessness
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8
Q

to diagnose mani episode according to DSM-5

A

3 out of the DIG FAST sxs/ four if mood is only irritable lasting for at least 1 week

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9
Q

distinct period of abnormally and persistently elevated, expansive or irritable mood, and abnormally and persistently increased goal-directed activity/energy lasting for 4 consecutive days and at least 3 of DIG FAST crit

A

hypomania

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10
Q

mania vs hypomania:

  1. lasts at least 7 days
  2. causes severe impairment in social/occupational functioning
  3. may necessitate hospitalization to prevent harm to self or others
  4. may have psychotic features
A

Mania

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11
Q

mania vs. hypomania:

  1. lasts at least 4 days
  2. no marked impairment in social/occupational functioning
  3. does not require hospitalization
  4. no psychotic features
A

hypomania

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12
Q

irritability is often the predominant mood state in mood disorders w/ mixed features. patients with mixed features have a poorer response to ________. anitconvulsants such as ________ maybe more helpful

A

irritability is often the predominant mood state in mood disorders w/ mixed features. patients with mixed features have a poorer response to Lithium. anitconvulsants such as valproic acid (depekote) maybe more helpful

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13
Q

mood disorders often have chronic courses that are marked by relapses w/ abnorma/normal? functioning between episodes

A

normal functioning

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14
Q

medical causes of a depressive disorder

A 
Cerebrovascular disease (stroke, MI)
endocrinopathies
parkinsons 
viral illness (mono)
carcinoid 
cnacer (lymphoma/ pancreatic)
collagen vacular disease ( sle)
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15
Q

medical causes of a manic episodes

A

metabolic
neurological disordes
neoplasms
HIV infection

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16
Q

___ patients are ata significant risk for developing depression and is associated with a poorer outcome overall

A

stroke

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17
Q

_________ is the most common disorder among those who complete suicide

A

Major depressive disorder

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18
Q

______ marked by epsiodes of depressed mood associated with loss of interest in daily activities. diagnosis by DSM-5 crit: at least one major depressive disorder and no history of manic or hypomanic episode

A

MDD

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19
Q

the 2 most common types of sleep disturbances associated with MDD are

A

(1) difficulty falling asleep and (2) early morning awakenings

20
Q

some biological things that we might see in MDD (3)

A
  1. increased sensitivity of beta-adrenergic receptors in the brain
  2. high cortisol
  3. abnormal thyroids axis
21
Q

combined treatment with both an __________ and ______________ produce a significantly increased response to MDD

A

antidepressent and antipsychotic

22
Q

serotonin syndrome is marked by

A
  1. autonomic instability
  2. hyperthermia
  3. hyperreflexia
23
Q

adjunctive treatment is usually perfomed in MDD after

A

multiple first-line treatment failures

24
Q

first line treatmetn for MDD

A

SSRIs

25
Q

adjunct medications for MDD

A
  1. atypical antipsychotics esp. MDD w/ psychotic features
  2. T3/T4/Lithium for refractory MDD
  3. stimulants but efficacy is limited
26
Q

triad for seasonal affective disorder

A
  1. irritability
  2. carbohydrate craving
  3. hypersomnia
27
Q

MDD w/ psychotic features is best treated with combination of

A

antidepressent and antipsychotic or ECT

28
Q

reaction to a major loss– loss of a loved one and is not a mental illness

A

bereavement– simple grief

29
Q

defined by the occurrence of four or more moos episodes in 1 year (MDD, hypomania or mania )

A

rapid cycling

30
Q

involves episodes of mania and of major depression; episodes of major depression not required for diagnosis

A

Bipolar I–manic-depression

31
Q

which has the highest genetic link of all major psychotic disorders

A

Bipolar I

32
Q

treatment for Bipolar I

A
  1. lithium– reduction in suicide risk
  2. carbamazepine or valproic acid — particularly useful for rapid cycling bipolar disorder w/ mixed features
  3. atypical antipsychotics– monotherapy and adjunct therapy
33
Q

what treatment is discouraged in Bipolar I ?

A

antidepressents– activating mani or hypomania

34
Q

best treatment for a pregnant woman who is having a manic episode

A

ECT

35
Q

history of one or more episodes of Major depressive disorder and at least one episode of hypomanic episode

A

Bipolar II– recurrent major depressive episode with hypomania

***** if there has been a full manic episode even in the past then the diagnosis is bipolar I and not bipolar II

36
Q

bipolar II (1) prognosis and (2) treatment

A

(1) tends to be chronic, requiring long-term treatment. liekly better prognosis than bipolar I
(2) fewer studies focus on the treament for bipolar II– same treatment as bipolar I

37
Q

MDD is an ____________ while persistent depressive disorder is ____________

A

MDD is an episodic illness while persistent depressive disorder is pervasive

38
Q

sxs. of persistent depressive disorder (dysthymia)– 2 or more of :

A

CHASES

  • poor concentration or difficulty naking decisions
  • feelings of hopelessness
  • poor appetite or overeating
  • insomnia or hypersomnia
  • low energy or fatigue
  • low self-esteem
39
Q

catatonia in bipolar disorders is responsive to

A

ECT

40
Q

DSM-5 crit for depressive disorder

A

2 Ds:

  1. 2 years of depression
  2. 2 of the CHASES
  3. never asymptomatic for >2 months
  4. never have a manic or hypomanic episode

** may have MDD

41
Q

depressive disorder (1) prognosis and (2) treatment

A

(1) early and insidious onset with a chornic course. depressive sxs much less likely to resolve thatn in MDD
(2) combination with psychotherapy and pharmacotherapy is more efficacious than alone

42
Q

alternating periods of hypomania and periods with mild-to-moderate depressive sxs for at least 2 years and never asymptomatic for > 2 months . no history of MDD, hypomania or manic episodes

A

cyclothymic disoder

43
Q

cyclothymic disorder (1) prognosis and (2) treatments

A

(1) chronic course– approx. 1/3 pt. eventually develop bipolar I/II disorder
(2) antimanic agents– mood stabilizers or second generation antipsychotics

44
Q

mood liability, irritibality, dysphoria and anxiety that occur repeatedly during the premenstrual phase of the cycle

A

premenstrual dysphoric disorder

45
Q

premenstrual dysphoric disorder (1) course (2) treatment

A

(1) sxs may worsen prior to menopause but cease after menopause
(2) SSRI are first-in line treatment either as daily therapy or luteal phase therapy. OCP may reduce sxs

46
Q

chronic, severe persistent irritability occurring in childhood and adolescence

A

disruptive mood dysregulation disorder – DMDD

47
Q

disruptive mood dysregulation disorder (1) course (2) treatment

A

(1) DMDD must occur prior to 10 years, rate of conversion to bipolar is low but high rates of cobormobidities such as ODD, ADHD, mood disorders and anxiety disorders
(2) no evidence based treatment– psuchotherapy is used

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