Mood disorders- NOT pharm- part 1- Exam 2 Flashcards
______ overall state of emotion at a given time
Influenced by internal and external factors
Internal condition visible through external behaviors
mood
Mood can be influenced by ____ and _____ factors
internal and external factors
_____ a condition that affects a person’s everyday emotional state/mood
mood disorder
What 3 neurotransmitters are regulated by our mood
Serotonin
Norepinephrine
Dopamine
**what 3 conditions must be present in all psych condition in order to make a diagnosis
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.
____ is the average age of onset for MDD. MDD is more common in _____ socioeconomic status
30 years old, more common in women
low socioeconomic status
Name some risk factors for MDD
Genetics/Biological
Life Events
Medications
Personality
Social
Medical conditions
**____ and ___ are medications and risk factors for MDD
steroids and interferons
What is the criteria to correctly diagnosis someone with Major Depressive Disorder
depressed mood OR anhedonia for longer than 2 weeks!
AND
4 or more of the following
(picture)
What is the mnemoic for diagnosing MDD
What are some MDD episode subtypes
In order to have MDD, a patient must have _____. It normally take _____ to develop
at least one major depressive episode
develop over days to weeks
_____ is the average time to resolution for a major depressive episode. When is the highest risk of recurrence?
20 weeks
within the first few months following an episode
____ is the rate of recurrence within the first year
____ is the rate of recurrence with a lifetime
40% in the first year
85% in a lifetime
Name some conditions that should be on your ddx for MDD
other mood disorders
substance use/abuse
medication SE
general medical disorders
____ is the quick initial screening for depression. What does it cover?
PHQ-2
asks about depressed mood or lack of interest
_____ is what you use to further evaluate presence and severity of depression
Patient health questionnaire (PHQ-9)
asks about SIG E CAP
What are some non-pharmacological treatment options for MDD
Psychotherapy
Electroconvulsive Therapy (ECT)
Vagal Nerve Stimulation
Transcranial Magnetic Stimulation (TMS)
Relaxation techniques
Bahavioral activation (restarting activites)
Exercise
Massage therapy/yoga/acupuncture
**What is the preferred approach for MDD? What is the treatment goal?
COMBINATION of pharmacotherapy AND psychotherapy
to achieve full remission of symptoms and return pt to baseline functioning
____ use of a small electric current to induce a cerebral seizure while patient is under general anesthesia
Electroconvulsive Therapy (ECT)
When is Electroconvulsive Therapy (ECT) most commonly used? When is it the first line treatment?
MC used for patients with severe, refractory depression
severe suicidality, severe psychosis, catatonia, malnutrition d/t food refusal secondary to depressive illness
Use caution in these patients while using ECT
Use caution in patients with cardiopulmonary disease, neurologic disease, or those on anticoagulants
What are the MC adverse events with ECT?
cardiopulmonary, HA, nausea, transient cognitive impairment, muscle aches
____ 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
Vagal nerve stimulation
____ Metal coil with magnetic field is placed against scalp to induce depolarization of neurons in a focal area
Performed outpatient without sedation or anesthesia
Transcranial Magnetic Stimulation (TMS)
What are the CI for Transcranial Magnetic Stimulation (TMS)? What are the SE?
High seizure risk, incompatible implants (metallic, electrical, cochlear)
Seizures, HA, scalp pain, transient hearing loss
Is ECT or TMS more efficacious?
ECT works better
