OnlineMedEd: Psychiatry - Mood Disorders

Question 1

________________ used to be a subtype of schizophrenia in the DSM-IV. It is now more associated with depression.

Answer 1

Catatonia

Question 2

There are three key diagnostic criteria for major depressive disorder. What are they?

Answer 2

• Depressed mood or anhedonia
• At least five of the SIGECAPS symptoms
• Duration greater than 2 weeks

Question 3

When screening for depression, you need to assess _______________.

Answer 3

suicidality

Question 4

If a person has suicidal ideation but no plan, what is the recommended course of action?

Answer 4

Instead of hospitalizing them, you need to have them undergo a “safety contract” in which they agree to call you or another health professional if they intend to suicide.

Question 5

What are treatment guidelines for depression?

Answer 5

• Initiate SSRI or SNRI and follow-up at 1 or 2 months for tolerance and efficacy
• Begin psychotherapy, CBT, counseling, or talk therapy
• Electroshock therapy (for refractory depression, catatonia, or psychosis)

Question 6

What two features are characteristic of atypical depression?

Answer 6

Increased sleep and appetite

Question 7

Why is “bipolar I” a poor name for the disorder?

Answer 7

Bipolar I is defined solely by mania, so calling it “mania” would make more sense.

Question 8

Go through OnlineMedEd’s mnemonic for mania symptoms.

Answer 8

Distractibility
Insomnia
Grandiosity
Flight of ideas
Activities / Agitation
Sexual exploits
Talkative
Elevated mood
Racing thoughts

Question 9

When evaluating a person with suspected mania, you need to rule out ______________.

Answer 9

amphetamine usage

Question 10

To qualify as mania, what two criteria need to be met?

Answer 10

• Elevated mood with three or more of the DIGFASTER symptoms
• Duration greater than one week

Question 11

How should an acutely manic person be managed?

Answer 11

• Treat immediately with antipsychotics like quetiapine

* Treat chronically with mood stabilizers like lithium, valproate, carbamazepine, or lamotrigine

Question 12

What is the order of medications for longterm mania treatment?

Answer 12

1) . Lithium
2) . Valproic acid
3) . Lamotrigine or carbamazepine
4) . Antipsychotics (quetiapine, risperidone, ziprasidone, aripiprazole, olanzapine)

Question 13

If you suspect bipolar II disorder but the person then displays symptoms of catatonia or psychosis, then the diagnosis has to be _______________.

Answer 13

bipolar I