Mood Disorders

Question 1

Kraepelinian definition of manic depressive illness?

Answer 1

ANY recurrent mood episodes of any kind

[depressive OR manic] constituted the diagnosis of MDI. Thus, MDI meant bipolar illness plus unipolar depressive illness

Question 2

mood or affective disorder?

Answer 2

where the fundamental disturbance is a change in affect or
mood to depression (with or without associated anxiety) or to
elation > mood change is usually accompanied by a change in the
overall level of activity

Question 3

lifetime rate of major depressive disorder?

Answer 3

10-20%

Question 4

global epidemiology of major depressive disorder

Answer 4

reasonably consistently documented an increasing

rate of MDD with an earlier age of onset

Question 5

gender distribution of bipolar I, bipolar II, major depressive disorder

Answer 5

F=M - bipolar I

F>M (2:1 for MDD) bipolar II, MDD

Question 6

outline typical cycle of low mood (unipolar and bipolar depression)

Answer 6

thoughts ‘whats the point?’ > feelings ‘low, flat, irritable’ > physiological symptoms ‘exhaustion’ > behaviours ‘lie in bed and ruminate’
ALL ARE INTERCONNECTED TOO

Question 7

list DSM-5 criteria for a depressive episode

Answer 7

2 wks + of depressed mood AND the presence of 4 of 8 out of the following: sleep alterations, appetite alterations, anhedonia, decreased concentration, low energy, guilt, psychomotor changes (agitation or retardation), suicidal thoughts

Question 8

If no manic or hypomanic episodes in the past are identified, then the diagnosis of a
current major depressive episode leads to a longitudinal diagnosis of?

Answer 8

major depressive disorder

Question 9

list subtypes in DSM-5 for MDD

Answer 9

Atypical features (which represent mainly increased sleep and appetite, along
with heightened mood reactivity)
Melancholic features (defined by no mood reactivity, along with marked
psychomotor retardation and anhedonia)
Psychotic features (the presence of delusions/hallucinations).

Question 10

depression triad - core symptoms

Answer 10

low mood
anergia
anhedonia

Question 11

depression triad - psychological symptoms

Answer 11

the world
the future
oneself

Question 12

depression triad - biological symptoms

Answer 12

sleep
libido
appetite

Question 13

outline the typical cycle of high mood

Answer 13

thoughts ‘im the best’ > feelings ‘elation, excitement’ > physiological symptoms ‘^energy’ > behaviours ‘impulsive, ^activity’
ALL ARE INTERCONNECTED TOO

Question 14

manic episode criteria according to DSM-5

Answer 14

Euphoric or irritable mood with 3 or more of 7 manic criteria: Decreased need for sleep with increased energy, Distractibility, Grandiosity or inflated self-esteem, Flight of ideas or racing thoughts, Increased talkativeness or pressured speech, Increased goal-directed activities or psychomotor agitation, Impulsive behaviour (such as sexual impulsivity or spending sprees)

Question 15

how is a manic episode diagnosed according to DSM-5 criteria?

Answer 15

symptoms are present for minimum 1 week with notable functional
impairment

Question 16

diagnosis of a manic episode leads to what diagnosis?

Answer 16

type I

bipolar disorder

Question 17

how is a hypomanic episode diagnosed according to DSM-5 criteria?

Answer 17

symptoms are present for at minimum 4 days, but without notable functional
impairment

Question 18

how is type II bipolar disorder diagnosed according to DSM-5 criteria?

Answer 18

not a single manic episode had occurred ever, but only hypomanic episodes are
present, along with at least one major depressive episode

Question 19

how is unspecified bipolar disorder diagnosed according to DSM-5 criteria?

Answer 19

manic symptoms occur for less than 4 days, or if other specific thresholds are not met for
manic or hypomanic episodes

Question 20

how can manic episodes by characterised?

Answer 20

by psychotic features

Question 21

If psychotic features are present, then ______ cannot be diagnosed

Answer 21

hypomania
(since such features
involve notable impairment by definition).

Question 22

If manic or hypomanic episodes are caused by antidepressants, is bipolar diagnosis still made?

Answer 22

yes

Question 23

what are the most consistent clinical features for diagnosis of bipolar disorders?

Answer 23

psychomotor changes

Question 24

compare the illness course of bipolar I and bipolar II

Answer 24

bipolar I mood swings between mania and depression

bipolar II from depression but manic episodes not like bipolar I

Question 25

the majority of episodes in bipolar I are?

Answer 25

depressive

Question 26

30-70& of bipolar patients also have what other mental illness?

Answer 26

anxiety

Question 27

compare insight between depression and mania

Answer 27

insight preserved in depression and impaired in mania

Question 28

how is insight along a spectrum from hypomania to severe mania?

Answer 28

U-shaped curve in relation to severity; it
is most impaired in hypomania and in
severe mania but may be more present in moderate states of mania

Question 29

What mood disorder diagnosis can easily be missed?

Answer 29

Bipolar diagnosis might be missed in a patient due to lack of insight about mania/hypomania

Question 30

what diagnosis

are bipolar patients likely to be misdiagnosed with?

Answer 30

Patient might end up with a MDD diagnosis despite a history of manic episodes

Question 31

therapeutic relevance of a distinction between bipolar and unipolar illness?

Answer 31

antidepressants mostly effective in acute bipolar depression + prophylaxis, can cause acute manic/hypomanic episodes, worsens the long-term course of bipolar illness in some, especially w/ a rapid- cycling course