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Block 8 Week 1 > Mood Disorders- Jacobs > Flashcards

Mood Disorders- Jacobs Flashcards

1
Q

THere are 5 different depressive disorders, what are they?

A
  • Major Depressive Disorder
  • Dysthymic Disorder (DSM-IV) or Persistent Depressive Disorder (DSM-V)
  • Premenstrual Dysphoric Disorder
  • Disruptive Mood Dysregulation Disorder (DSM-V)
  • Depressive Disorder NOS, specified or unspecified
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2
Q

What are the four types of bipolar disorders?

A
  • bipolar I disorder
  • bipolar II disorder
  • cyclothymic disorder
  • bipolar disorder NOS
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3
Q

What are secondary mood disorders?

A
  • Mood Disorder Due to a General Medical Condition

- Medication/Substance-Induced Mood Disorder

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4
Q

What is the most common psychiatric illness you are likely see as a physician?

A

depression (unipolar)

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5
Q

What are co-morbidities of depression?

A

-substance use disorders, pathological gambling, personality disorders, anxiety

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6
Q

Who are more likley to be depressed?

A

Women

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7
Q

Medical students are more likley to be depressed than normal student. WHat years are the most depressive years?

A

3rd and 4th year

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8
Q

Who were more depressed, married or single people?

A

single people

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9
Q

How many physicians do you lose a year to suicide? Are the majority female or male?

A

400

it is equal

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10
Q

What are things to consider before diagnosing someone with depression?

A
  • bereavement
  • normal reaction to stress or loss
  • adjustment disorder
  • cultural factors
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11
Q

What is the criterion or a major depressive disorder?

A
  • 2 weeks or more of symptoms
  • 5 or more of possible 9 symtpoms (one of which must be depressed mood or loss of interest/pleasure)
  • marked distress or functional impairment
  • rule out medical and substance etiologies
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12
Q

What are the 9 symptoms of major depressive disorder?

A
  • mood
  • loss of interest
  • weight or app changes
  • sleep changes
  • agitation or retardation
  • fatigue
  • worthlessness or guilty
  • thinking problems
  • thoughts of death
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13
Q

What is the mneumonic for Depression screening?

A 
SIGECAPS
S-sleep
I-interest reduced
G-guilt
E-energy loss and fatigue
C- concentrations problems
A-appetite changes
P- psychomotor changes
S- Suicidal thoughts
(ask about mood)
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14
Q

What are the (neuro)vegetative symptoms?

A
  • sleep disturbance
  • appetite problems
  • loss of energy
  • decreased libido
  • psychomotor retardation/agitation
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15
Q

What are the three ways you can have sleep disturbances?

A

initial, middle,terminal insomnia

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16
Q

When you have appeptite problems associated with major depressive disorder are you eating too much or not enough?

A

not enough

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17
Q

WHat are possible “companions” to depression?

A 
nausea
constipation
headaches
back pain
shortness of breath*
chest pain*
*anxiety type symptoms
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18
Q

In major depressive disorder, 50% onset between ages (blanK) and (blank)

A

20 and 30

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19
Q

What is the peak incidence of major depressive disorder?

What is the median age of onset?

A

20s

32

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20
Q

How long can a single episode of major depressive disorder last?

A

6-13 months untreated

1-3 months treated (faster with ElectroConvulsiveTherapy)

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21
Q

What is the percent of MDD patients that relapse? What percent commit suicide?

A

70%

15% commit suicide

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22
Q

What is persistent depressive disorder?

A

2 years of low mood (1 year for children/adolescents)

  • milder, more fluctuating symptoms
  • presence 2 additional symptoms (appetite, sleep, fatigue, self esteem, concentration, hopelessness)
  • distress or impaired functioning
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23
Q

What gender is more likely to have persistent depressive disorder?

A

women

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24
Q

What do you call this:

persistent depressive disoder with a shorter more severe episode

A

double depression

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25
Q

What is premenstrual dysphoric disorder?

A

greater than 5 symptoms present during the week before menses

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26
Q

What are the symptoms of dysophoric disorder?

A

B. > 1 symptoms: affective lability, irritability/anger/conflict, depressed mood, anxiety
C. > 1 symptoms: anhedonia, difficulty concentrating, lethargy, change in appetite, hypersomnia/insomnia, overwhelmed/out of control, physical symptoms (bloating, pain, weight gain, etc)
D. causing clinically significant distress or interference with functioning

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27
Q

A depressive disorder due to a general medical condition (A prominent and persistent disturbance in mood that is judged to be due to the direct pathophysiological consequence of another medical disease). . WHat are some examples of diseases that cause this?

A 
Malignancy
autoimmune
infectious
GI
metabolic
endocrine
pulmonary
CV
neuro
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28
Q

What is a substance-induced depressive disorder?

A

A prominent and persistent disturbance in mood that is judged to be due to the physiological effect of a substance or medication

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29
Q

What are some drugs that cause substance-induced depressive disorders?

A

Alcohol, benzos, opoids

  • hallucinogens (including cannabis)
  • withdrawal from stimulants (meth, cocaine)
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30
Q

What are some other substance induced depressive disorder caues?

A

oral contraceptives
steroids
anti-hypertensives (reserpine, beta blockers etc.)

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31
Q

What is disruptive mood dysregulation disorder?

A

characterized by severe recurrent temper outbursts in response to common stressors

  • occuring for 12 months
  • in at least 2 settings
  • 3 X or more a week
  • have to be at least 6 and onset has to be before 10 and cant be over 18
32
Q

How are the temper outbursts of disruptive mood dysregulation disorder manifested?

A

verbally and/or behaviorally such as verbal rage or agression

33
Q

What is this:

Other Specified/ Unspecified Depressive Disorders

A

Clinically significant depressive syndromes not meeting criteria for established categories of depression.
Clinician specify or not specify reasons that full criteria are not met (i.e., short duration, insufficient symptoms)

34
Q

What is this:

exposure to uncontrollable negative events plus attributional style

A

Learned Helplessness Model

35
Q

What are some theories behind the etiology of depression?

A
  • learned helplessness
  • cognitive theory
  • genetics of depression
  • biology of depression
36
Q

Is depression genetic?

A

yes, has strong familial pattern, and children of depressed parents who are adopted out are at increased risk for depression

37
Q

If you have a first degree relative who is depressed, you are (blank) times more likely than the generally pop to be depressed

38
Q

What are the 6 pertinent biogenic amides?

A
  • dopamine
  • epinephrine
  • acetylcholine
  • norepinephrine
  • histamine
  • serotonin
39
Q

What is this

made in the locus ceruleus

A

norepinephrine

40
Q

What is this:
made in the dorsal raphe nuclei in the pons
decreased CSF 5HIAA levels in those who die of violent suicide

41
Q

WHat is this:

made in VTA of the midbrain, substantia nigra parts compacta, and arcuate nucleus

42
Q

What is the indeoleamine hypothesis?

A

deficit of 5 HT causes depression

43
Q

What is the catecholaine hypothesisi?

A

deficit of NE or DA cause depression

44
Q

WHat is the cholinergic-adrenergic balance hypothesis?

A

depression occurs when NE and DA are low relative to Ach, and mania occurs when the reverse occurs

45
Q

What is the neuroendocrine model?

A

hypothalamus hypersecretes CRF in depression, resulting in elevated ACTH, which triggers adrenal cortex to releaase cortisol that cannot be suppressed with dexamethasone.

46
Q

How do you treat neuroendocrine depression?

A

with ketoconazole which lowers cortisol levels and can be efficacious in treatment-resistant depression

47
Q

What is the infectious model behind depression?

A

the Borna virus and other infectious agents can cause depression; the antiviral amantadine can be helpful

48
Q

In Bipolar I, what are signs of manic episodes?

A

Mood: elevated (or irritable, can be labile) lasting one week

activity: increase in goal directed activity or energy lasting at least one week
- 3 symptoms

49
Q

What are the symptoms of manic episodes?

A

Grandiosity, decr need for sleep, pressured speech, flight of ideas/racing thoughts, distractibility, incr goal-directed activity or psychomotor agitation, risky behaviors

50
Q

IF you are manic but irritiable not elevated, how many extra symptoms do you need?

51
Q

Are transient mood swings indicative of bipolar disorders?

52
Q

How can you identify the most recent bipolar episode?

A
  • Single manic episode
  • Most recent episode hypomanic
  • Most recent episode manic
  • Most recent episode depressed
  • Most recent episode unspecified
53
Q

What is the age of onset of bipolar I?

A

20-30

manic episodes lasts weeks to months

54
Q

If you give an antidepressent for someone on their first depressive episode of bipolar disorder, what can happen?

A

you can induce a manic episode

55
Q

What disoder has the stronest genetic component?

A

Bipolar disorder

56
Q

First degree relatives are (blank) times more likley to have bipolar disorder

57
Q

IS bipolar II more intense or less intesnt than Bipolar I?

58
Q

What is in your differential of bipolar I?

A

Drugs or Medical Illness
Bipolar II
Schizoaffective Disorder
Cyclothymia

59
Q

If you have right frontal head trauma what can result?

60
Q

If you have left frontal head trauma what can result?

A

depression

61
Q

If you have medial frontal head trauma what can result?

62
Q

If you have orbitofrontal lobe trauma what can result?

A

profanity, irritability, irresponsibility

63
Q

T or F

bipolar disorder can be due to another medical condition

64
Q

T or F

manic moods can be induced by drugs?

65
Q

What are drugs of abuse that can resemble a bipolar manic episode?

A

LSD, stimulants (meth) PCP

66
Q

What medications can cause medication induced bipolar disorder?

A

Steroids, L dopa, thyroxine, captopril
Drug withdrawal
-clonidine

67
Q

What is a hypomanic episode?

A

at least 4 days of elevated mood + increase in goal-directed activity or mood

  • 3 or more other symptoms (4 if mood is just irritable)
  • change in functioning
  • not severe enough to severely impair functioning or necessitate hospitalization
  • no psychosis
68
Q

What defines a bipolar type II disorder?

A

hypomanic episode + major depressive episode

  • never a history of manic episodes
  • treatment same as BP I
69
Q

What the difference between manic and hypomanic episodes?

A

manic-impairment of functiong, lasts a week

hypomanic- no impairment of functioning, lasts 4 days

70
Q

What is the difference between bipolar I and bipolar II?

A

bipolar I- involves a manic episode, involves depressive episode
bipolar II- at least one major depressive episode and one hypomanic episode with no history of manic episodes

71
Q

If you ever had a manic episode what are you????

72
Q

What is schizoaffective disorder?

A

combing aspects of 2 different disorders

  • shizophrenia symptoms (psychosis, negative symptoms)
  • Prominent affective (mood) symptoms
  • psychotic symptoms present even when mood symptoms are absent
73
Q

In schizoaffective disorder, psychotic symptoms must occur for at least (blank) weeks in the ABSENCE of prominent mood symptoms

74
Q

If psychotic symptoms occur ony in the context of mood symptoms, then think (Blank)

A

mood disoder with psychotic features

75
Q

What is cyclothymic disoder?

A
  • chronic mood disturbance (over 2 years)
  • hypomanic symptoms that don’t meet criteria for a hypomanic episode
  • depressive symptoms that don’t meet criteria for a major depressive episode
  • no history of depressive, manic, or hypomanic episodes
  • clinically signif distress or functional impairment

Block 8 Week 1 (13 decks)

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