Mood disorders- NOT pharm- part 1- Exam 2

Question 1

______ overall state of emotion at a given time
Influenced by internal and external factors
Internal condition visible through external behaviors

Answer 1

mood

Question 2

Mood can be influenced by ____ and _____ factors

Answer 2

internal and external factors

Question 3

_____ a condition that affects a person’s everyday emotional state/mood

Answer 3

mood disorder

Question 4

What 3 neurotransmitters are regulated by our mood

Answer 4

Serotonin
Norepinephrine
Dopamine

Question 5

**what 3 conditions must be present in all psych condition in order to make a diagnosis

Answer 5

The condition is not caused by the direct effects of any drug or external exposure

The psychiatric disorder is not caused by effects of a medical condition

There is significant impairment of social functioning, occupational functioning, or both.

Question 6

____ is the average age of onset for MDD. MDD is more common in _____ socioeconomic status

Answer 6

30 years old, more common in women

low socioeconomic status

Question 7

Name some risk factors for MDD

Answer 7

Genetics/Biological
Life Events
Medications
Personality
Social
Medical conditions

Question 8

**____ and ___ are medications and risk factors for MDD

Answer 8

steroids and interferons

Question 9

What is the criteria to correctly diagnosis someone with Major Depressive Disorder

Answer 9

depressed mood OR anhedonia for longer than 2 weeks!

AND

4 or more of the following
(picture)

Question 10

What is the mnemoic for diagnosing MDD

Answer 10

Question 11

What are some MDD episode subtypes

Answer 11

Question 12

In order to have MDD, a patient must have _____. It normally take _____ to develop

Answer 12

at least one major depressive episode

develop over days to weeks

Question 13

_____ is the average time to resolution for a major depressive episode. When is the highest risk of recurrence?

Answer 13

20 weeks

within the first few months following an episode

Question 14

____ is the rate of recurrence within the first year

____ is the rate of recurrence with a lifetime

Answer 14

40% in the first year

85% in a lifetime

Question 15

Name some conditions that should be on your ddx for MDD

Answer 15

other mood disorders
substance use/abuse
medication SE
general medical disorders

Question 16

____ is the quick initial screening for depression. What does it cover?

Answer 16

PHQ-2

asks about depressed mood or lack of interest

Question 17

_____ is what you use to further evaluate presence and severity of depression

Answer 17

Patient health questionnaire (PHQ-9)

asks about SIG E CAP

Question 18

What are some non-pharmacological treatment options for MDD

Answer 18

Psychotherapy
Electroconvulsive Therapy (ECT)
Vagal Nerve Stimulation
Transcranial Magnetic Stimulation (TMS)
Relaxation techniques
Bahavioral activation (restarting activites)
Exercise
Massage therapy/yoga/acupuncture

Question 19

**What is the preferred approach for MDD? What is the treatment goal?

Answer 19

COMBINATION of pharmacotherapy AND psychotherapy

to achieve full remission of symptoms and return pt to baseline functioning

Question 20

____ use of a small electric current to induce a cerebral seizure while patient is under general anesthesia

Answer 20

Electroconvulsive Therapy (ECT)

Question 21

When is Electroconvulsive Therapy (ECT) most commonly used? When is it the first line treatment?

Answer 21

MC used for patients with severe, refractory depression

severe suicidality, severe psychosis, catatonia, malnutrition d/t food refusal secondary to depressive illness

Question 22

Use caution in these patients while using ECT

Answer 22

Use caution in patients with cardiopulmonary disease, neurologic disease, or those on anticoagulants

Question 23

What are the MC adverse events with ECT?

Answer 23

cardiopulmonary, HA, nausea, transient cognitive impairment, muscle aches

Question 24

____ A device is implanted in the chest wall and connected to one (left) vagus nerve
Used primarily for refractory epilepsy
May be helpful for refractory depression

Answer 24

Vagal nerve stimulation

Question 25

____ Metal coil with magnetic field is placed against scalp to induce depolarization of neurons in a focal area
Performed outpatient without sedation or anesthesia

Answer 25

Transcranial Magnetic Stimulation (TMS)

Question 26

What are the CI for Transcranial Magnetic Stimulation (TMS)? What are the SE?

Answer 26

High seizure risk, incompatible implants (metallic, electrical, cochlear)

Seizures, HA, scalp pain, transient hearing loss

Question 27

Is ECT or TMS more efficacious?

Answer 27

ECT works better