Mood Disorders: Anxiety Disorders And Biolar Disorders Flashcards
How do we best define Bipolar 1 Disorder? Talk about what is required and what is not required for diagnosis.
Single manic episode
At least 1 manic or mixed episode. Major depressive episode is not required for diagnosis but it usually is the episode that presents first.
How do we define bipolar disorder type 2 for the purposes of diagnosis?
Patients have had at least one major depressive episode and one hypomanic episode in the absence of any manic or mixed episodes.
More prevalent than type 1
What is first line treatment for bipolar disorders, what family of drugs?
What are the three specific drugs to use and their strengths as far as high part of the bipolar pole they treat best?
Talk about the patient populations we need to avoid with one fo the drugs.
Mood stabilizers: lithium, Valproic acid, and carbamazepine.
Lithium is good for the depression part of bipolar
Valproic acid is good for the manic part
Don’t use lithium in patients with kidney or thyroid issues
What is the clinical indication for lamotrigine?
Bipolar with depression
What are the 3 side effects to remember with second generation antipsychotics that end with pine?
Weight gain
Diabetes
Metabolic
Good definition of cyclothymic disorder?
Patient has experienced repeated episodes of hypomania and depression (not severe enough for MDD) over the last 2 years.
Intermittent hypomanic periods
What do we use to treat cyclothymic disorder and what to avoid in treatment and why?
Mood stabilizing drugs
Avoid antidepressants because they can set up manic episodes
What do we always monitor with patients on bipolar meds?
Blood levels of those drugs
Generalized anxiety often accompanies what other condition?
Panic anxiety
2 criteria for panic disorder?
- Recurrent unexpected panic attacks
- At least one attack followed by 1 month or more of concern of another attack and change in behavior related to the attacks
How do we define panic attack for the purposes of diagnosis?
Discrete period of intense fear or or discomfort in which 4 or more symptoms abruptly come on and reach peak intensity within 10 minutes and last up to 25 minutes.
Which gender is more affected by panic attacks?
Common age?
What etiological component?
Female
Young 20s
Half have at least one affected relative, strong genetic component
Explain agoraphobia’s role in panic disorder?
It’s not that these people are scared of the public, its that they are afraid to be somewhere where they are going to be trapped and then have a panic attack in that place they can’t get out of
Definition for social phobia or social anxiety disorder?
Fear, anxiety or avoidance typically lasting 6 or more months
Definition for the purposes of diagnosis for generalized anxiety disorder?
Excessive anxiety and worry occurring more days than not for at least 6 months, for most of the day, about a number of events or activities.
3 of the following must be associated with the worry: restlessness, fatigue, difficult concentrating, irritable, muscle tension, sleep is messed up
