Mood Disorders and Suicide Flashcards
What percent of patients with depression will by die suicide?
15% (high mortality rate)
What are the three types of specific mood disorders?
Major depressive disorder
Bipolar disorder
Persistent depressive disorder
What three neurotransmitters are involved in the biologic etiology of mood disorders?
Serotonin
Dopamine
Norepinephrine
What are some of the psychosocial etiologies contributing to mood disorders?
Stressful life events, trauma, ACE’s
Learned helplessness
Pessimism
Insult with genetic susceptibility
What is external locus of control?
Individual thinks things happen to them and they don’t have control of what happens to them
What is euthymia?
Normal ups and downs in mood
What is the screening tools for major depression?
PHQ-9 or MDI (Major Depression Inventory)
What score on the PHQ-9 requires treatment?
15 or higher
In adolescents/kids, how much time do symptoms need to be present in order to be diagnosed with major depression?
Must have 2+ years of symptoms and must not have a symptom free period of more than 2 months
What drug class is the first line pharmacotherapy treatment for major depression?
SSRI’s (all are about equal in efficacy)
How long should you try an SSRI for before changing agents or increasing dose?
At least 4-8 weeks
What criteria would require chronic treatment of major depression?
3+ episodes (lifetime)
2+ severe episodes
Co-morbid SUD or anxiety DO
> 60 years at onset
What are the side effects of SSRI’s?
Sexual dysfunction
Headache
GI upset
Increased anxiety
Insomnia
What is Cognitive Behavioral Therapy’s goal?
Identify cognitive distortions and give the patient homework to change thoughts and behaviors
What is required in the diagnosis for dysthymia?
Persistent low mood for 2+ years
What symptoms are present in MDD but not dysthymia?
Anhedonia
Psychomotor symptoms
Suicidal ideation
What is the screening tool for bipolar depression?
The Mood Disorder Questionnaire (MDQ)
What are the first line mood stabilizers in treating bipolar disorders?
Lithium (first line of all first lines)
Valproate
Carbamazepine
When is electroconvulsive therapy (ECT) indicated?
Patients who have failed pharm treatment or patients at high risk for suicide and need urgent treatment
What is transmagnetic stimulation (TMS) and what does it treat?
Noninvasive brain stimulation using magnetic impulses for treatment of resistant depression
When are symptoms present (what part of the menstrual cycle) in premenstrual dysphoric disorder?
The final week before menses (but also up to three weeks)
When considering age, race, and gender who is at highest risk for suicide?
Middle age caucasian men
What are some protective factors against suicide risk?
Religion/spirituality
Support system
Life satisfaction
Healthy coping mechanisms
Marriage
Children
Female gender
