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Psychiatry Part 2 > Other Random Psych > Flashcards

Other Random Psych Flashcards

1
Q

Lifetime prevalence of MDD in men? Women?

A

12% in men

20% in women

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2
Q

What is the RR of MDD in first degree relatives of probands?

A

2-3

41%:13% (monozygotic:dizygotic) condordance

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3
Q

SIG E CAPS?

A

Sleep, Interest, Guilt
Energy
Concentration, Appetite, Psychomotor, Suicide

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4
Q

Is bereavement an exclusion for MDD?

A

No because 2-month rule didn’t reflect reality, responds to same tx, same natural course

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5
Q

MDD + 2 or more of the following: keyed-up/tense, unusually restless, can’t concentrate b/c of worry, fear something awful will happen, might lose control

A

MDD with anxious distress

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6
Q

MDD + 3 or more manic/hypomanic sxs (minus distractibility)

A

MDD with mixed features

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7
Q

MDD + absolute anhedonia OR mood non-reactivity + 3 or more of the following: distinct quality of mood, worse in AM, early AM awakening, marked PMA or PMR, significant appetite or wt loss, excessive guilt

A

MDD with melancholic features

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8
Q

MDD + mood reactivity + 2 or more of the following: significant appetie or wt increase, hypersomnia, leaden paralysis, long-standing interpersonal rejection sensitivity leading to social/work problems

A

MDD with atypical features

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9
Q

What med works well for MDD with atypical features? What is first line?

A

SSRIs 1st line

MAOIs work well

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10
Q

MDD + delusions and/or hallucinations (congruent: personal inadequacy, guilt, death, nihilism, deserved punishment)

A

MDD with psychotic features (congruent or incongruent)

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11
Q

MDD + during MOST of the episode, 3 or more of the following: stupor, catalepsy, waxy flex, mutism, stereotypy, grimacing, echolalia, mannerisms, negativism

A

MDD with catatonia

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12
Q

MDD during pregnancy or in the 4 weeks after delivery

A

MDD with peripartum onset

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13
Q

MDD with relapses/remissions at characteristics times year (at least 2 MDE in last 2 yrs with no non-seasonal MDE)

A

MDD with seasonal pattern

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14
Q

If patients always gets depressed with seasonal unemployment (or beginning of school year), is that MDD with seasonal pattern?

A

NO!

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15
Q

Do antidepressants have additional actions besides inhibition of reuptake transporters?

A

Ys, increase neurogenesis in hippoccampus

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16
Q

What is the response rate to SSRIs in MDD?

A

47%

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17
Q

What is the remission rate with SSRIs in MDD?

A

33%

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18
Q

What is the remission rate with ECT in MDD?

A

80-90%

19
Q

What is the relapse rate at 6 months with ECT in MDD?

A

50-80%

20
Q

How many with MDD recover within 3 months? 1 year?

A

2 in 5 recover in 3 months

4 in 5 recover in 1 year

21
Q

What’s the risk of subsequent MDE if 1 episode in last 3 years? 2 episodes? 3 episodes?

A

1 episode = 50%
2 episodes = 70%
3 episodes = 90%

22
Q

What percent of MDD will eventually be diagnosed with bipolar? RIsk factors?

A

5-10%
Onset of MDD in adolescence
Family hx of bipolar
‘Mixed fx’

23
Q

What is the lifetime suicide risk with MDD?

A

6%, up to 15% with severe MDD

24
Q

Persistent depressive disorder (dysthymia)

A

2 yrs depressed mood (1 yr in kids/adolescents) most of the day, more days than not, PLUS 2 of the following:
- appetite change - sleep change - low energy - low esteem - poor concentration - hopeless
Never sx free for more than 2 months

25
Q

What is early onset MDD or dysthymia?

A

Before age 21

26
Q

Can you have MDD and dysthymia?

A

YES!

w/ persistent MDE, w/ intermittent MDE

27
Q

Lifetime prevalence of persistent depressive disorder? 12-month prevalence?

A

6% lifetime

0.5% 12 month prevalence (compared with 1.5% for MDD)

28
Q

Persistent depressive disorder has high comorbidity with what?

A

Personality disorder (esp. clusters B, C)

29
Q

Premenstrual dysphoric d/o

A

In most menstrual cycles, 5 or more sxs in week before onset with improvement after onset
PLUS
1 or more: mood lability, irritability, anxiety
PLUS
1 or more: anhedonia, impaired conc., anergia, appetite change, sleep change, feeling overwhelmed, physical sxs (breast tenderness, bloat)

30
Q

How do you diagnose premenstrual dysphoric d/o?

A

Prospective daily rating scales during at least 2 symptomatic cycles

31
Q

Tx for Premenstrual dysphoric d/o?

A

SSRI daily or luteal phase only

OCP for anovulation

32
Q

Disruptive mood dysregulation disorder?

A

6-18 y/o
Severe temper outbursts, not appropriate, 3 or more per week, usually irritable mood for more than 12 months in 2 settings, can’t be symptom free more than 3 consecutive months

33
Q

Disruptive mood dysregulation disorder onset must be BEFORE what age?

A

10 y/o

34
Q

Why does disruptive mood dysregulation disorder diagnosis exist?

A

Avoid excessive dx of bipolar disorder in kids

35
Q

BD prevalence?

A
  1. 4-1.6% bipolar I

0. 5% bipolar II

36
Q

RIsk of BD with 1 first degree relative? Risk of BD with 1 second degree relative?

A

7% (up from 1%) with first degree

Stays 1% with second degree

37
Q

Specifiers for rapid cycling BD?

A

4 mood episodes per year

20-30% of BD patients, 2/3 are women

38
Q

Manic switch in BD with what meds?

A

Reuptake blockers

Lamotrigine!

39
Q

What is the lifetime prevalence of at least one suicide attempt in BD?

A

35%

40
Q

Risk of suicide completion in BD vs. general population?

A

15x higher risk

41
Q

What is the suicide completion rate in BD?

A

15%

42
Q

Does BD1 or BD2 have more lethality of suicide attempts?

A

BD2

43
Q

Cyclothymic disorder

A

2 y fluctuating mood (1 y in kids/adolescents) with hypomanic sxs (NOT EPISODES) and dysthymic sxs (NOT MDEs)

44
Q

Adjustment disorder?

A

Response to stressors within 3 months

Terminated within 6 months of end of stressor

Psychiatry Part 2 (8 decks)

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