Mood Disorders - Derreberry Flashcards
mood
description of ones emotional state
name two categories of mood disorders
bipolar
depressive
what is the criteria for major depressive episode
5 symptoms for at least 2 week period
what are the symptoms for major depressive episode
SIGECAPS sleep decreased interest guilt decreased energy decreased concentration change in appetite psychomotor retardation suicidal ideation
in order to be diagnosed with major depressive disorder they can’t have a history of what
mania
what gender is more likely to get major depressive disorder
females
what increases the chance of someone have a major depressive disorder
having a first degree relative
Are SSRI good for major depressive disorder
safe and well tolerated
what are side effects of SSRI
GI
headache
sexual symptoms
If a major depressive disorder patient is on TCA what test must be done on them
EKG, increases QTc
how long does it take for depressive medications to work
4-8 weeks
MAOIs if taken with what can increase the risk for what
tyramine
hypertensive crisis
Electroconvulsive therapy (ECT) is a good choice for what type of patients with major depressive disorder
elderly
pregnant
cannot tolerate pharmacotherapy
what are 5 features of major depressive disorder
melancholic atypical psychotic anxious distress catatonic
Melancholic
waking up early
depression worse in the morning
weight loss
atpyical
increase eating, sleeping
“leaden paralysis”
psychotic
delusions and hallucinations
catatonic
negativism
excessive motor activity
what is persistent depressive disorder ( dysthymic disorder)
depressed mood for about 2 years 2 of the following: CHASES poor concentration hopelessness poor or increased appetite InSomnia or hyperinSomnia low energy low self esteem
person has not been w/o sxs for more than 2 months
what is the dysthymia rule of 2’s
2 years depression
2 listed criteria
never asymptomatic for greater than 2 months
what are some risk factors for suidide
greater than 45 yrs
alcohol and substance abuse
history of violence
prior attempt
what is the best predictor for suicide
past attempt
does asking someone if they are suicidal plant the idea of suicide in their head
no
what condition increase risk of suicide
emergence from deep depression
In elderly suicide what should always be ruled out first
biological causes
hypothyroidism
How do elderly present when they are suicidal
physical complaints instead of saying they are depressed
Adjustment disorder
development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of onset of the stressor
Someone walks in office, just broke up with girlfriend, not sleeping or eating, can’t focus in class, does not enjoy Marshall football games anymore? what does he have
major depressive disorder
When assessing suicide risk in patient, what is the greatest risk
previous suicide attempt
what is manic disorder
abnormally and persistently elevated, expansive, or irritable mood lasting at LEAST ONE WEEK and associated with three criteria, 4 if mood is irritable
what are the criteria for manic and hypomania disorder
DIG FAST distractibility insomnia grandiosity flight of ideas activity/agitation speech thoughtlessness
what is the difference between hypomanic and mania
hypomanic same criteria except: lasts only 4 days no impairment in social functioning does not require hospitalization not due to drugs no psychotic features
kindling
after multiple stress induced episodes
for bipolar pathophysiology
what looks dysfunctional in Neuro-imaging findings for bipolar
anterior paralimbic and prefrontal
what is the criteria for bipolar I disorder
presence of at least 1 manic episode
does not need a depressive episode
can last up to 3 months without treatment
what are FIRST LINE agents for bipolar I disorder
Lithium and Valproic acid
what are side effects for Lithium
renal, thyroid dysfunction
tremor
weight gain
side effect for valprioic acid
liver dysfunction
pancreatitis
side effect for carbamazepine
bone marrow suppression
what is the criteria for bipolar II disorder
history of hypomania
have major depressive episode in past
what is the difference between bipolar I disorder and bipolar II disorder
II: major depressive episode in past
I: only need manic episode
I: history of psychosis (psychosis is part of mania)
I: more likely to lead to social consequences
what is psyhocosis
hallucinations
what is rapid cycling
four or more complete cycles a year
define mixed episode
criteria met for both manic/hypomanic episode and depressive episode
-present for at least 1 week
EMERGENCY
what is cyclothymic disorder
numerous periods with hypomanic symptoms and depressive symptoms ( not meeting criteria for both) for at least 2 years
