Mood Disorders and Suicide

Question 1

What percent of patients with depression will by die suicide?

Answer 1

15% (high mortality rate)

Question 2

What are the three types of specific mood disorders?

Answer 2

Major depressive disorder
Bipolar disorder
Persistent depressive disorder

Question 3

What three neurotransmitters are involved in the biologic etiology of mood disorders?

Answer 3

Serotonin
Dopamine
Norepinephrine

Question 4

What are some of the psychosocial etiologies contributing to mood disorders?

Answer 4

Stressful life events, trauma, ACE’s
Learned helplessness
Pessimism
Insult with genetic susceptibility

Question 5

What is external locus of control?

Answer 5

Individual thinks things happen to them and they don’t have control of what happens to them

Question 6

What is euthymia?

Answer 6

Normal ups and downs in mood

Question 7

What is the screening tools for major depression?

Answer 7

PHQ-9 or MDI (Major Depression Inventory)

Question 8

What score on the PHQ-9 requires treatment?

Answer 8

15 or higher

Question 9

In adolescents/kids, how much time do symptoms need to be present in order to be diagnosed with major depression?

Answer 9

Must have 2+ years of symptoms and must not have a symptom free period of more than 2 months

Question 10

What drug class is the first line pharmacotherapy treatment for major depression?

Answer 10

SSRI’s (all are about equal in efficacy)

Question 11

How long should you try an SSRI for before changing agents or increasing dose?

Answer 11

At least 4-8 weeks

Question 12

What criteria would require chronic treatment of major depression?

Answer 12

3+ episodes (lifetime)
2+ severe episodes
Co-morbid SUD or anxiety DO
> 60 years at onset

Question 13

What are the side effects of SSRI’s?

Answer 13

Sexual dysfunction
Headache
GI upset
Increased anxiety
Insomnia

Question 14

What is Cognitive Behavioral Therapy’s goal?

Answer 14

Identify cognitive distortions and give the patient homework to change thoughts and behaviors

Question 15

What is required in the diagnosis for dysthymia?

Answer 15

Persistent low mood for 2+ years

Question 16

What symptoms are present in MDD but not dysthymia?

Answer 16

Anhedonia
Psychomotor symptoms
Suicidal ideation

Question 17

What is the screening tool for bipolar depression?

Answer 17

The Mood Disorder Questionnaire (MDQ)

Question 18

What are the first line mood stabilizers in treating bipolar disorders?

Answer 18

Lithium (first line of all first lines)
Valproate
Carbamazepine

Question 19

When is electroconvulsive therapy (ECT) indicated?

Answer 19

Patients who have failed pharm treatment or patients at high risk for suicide and need urgent treatment

Question 20

What is transmagnetic stimulation (TMS) and what does it treat?

Answer 20

Noninvasive brain stimulation using magnetic impulses for treatment of resistant depression

Question 21

When are symptoms present (what part of the menstrual cycle) in premenstrual dysphoric disorder?

Answer 21

The final week before menses (but also up to three weeks)

Question 22

When considering age, race, and gender who is at highest risk for suicide?

Answer 22

Middle age caucasian men

Question 23

What are some protective factors against suicide risk?

Answer 23

Religion/spirituality
Support system
Life satisfaction
Healthy coping mechanisms
Marriage
Children
Female gender